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NPI Code Detail

MEDICARE: EDDY VALDEZ MD

MEDICARE: EDDY VALDEZ MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2208M00000XHospitalist PhysicianT3004TX

General Provider Information

NPI Number : 1710482286
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDDY VALDEZ MD
Provider Business Mailing Address
First Line : 5002 COWHORN CREEK RD
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-9766
Country : US
Telephone Number : 903-614-3000
Fax Number : 903-614-3525
Provider Business Practice Location Address
First Line : 1000 PINE ST
Second Line :
City : TEXARKANA
State : TX
Zip : 75501-5100
Country : US
Telephone Number : 903-614-3000
Fax Number : 903-614-3525
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2018
Last Update Date : 08/09/2021

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