MEDICARE: DR. RENE VALDEZ JR. DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	10869	TX

General Provider Information

NPI Number	:	1649438466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RENE VALDEZ JR. DC

Provider Business Mailing Address
First Line	:	7203 J CARPENTER FRWY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75247
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3721 N HALL ST
Second Line	:	APT 203
City	:	DALLAS
State	:	TX
Zip	:	75219-6402
Country	:	US
Telephone Number	:	972-281-9592
Fax Number	:	214-599-0599

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	05/29/2008

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