MEDICARE: MANUEL F VALENZUELA 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
1	208000000X	Pediatrics Physician	20030658	NM
2	208000000X	Pediatrics Physician	M1391	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851390454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANUEL F VALENZUELA MD

Provider Business Mailing Address
First Line	:	6633 N MESA ST STE 203
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4422
Country	:	US
Telephone Number	:	915-500-4093
Fax Number	:	915-500-4167

Provider Business Practice Location Address
First Line	:	6633 N MESA ST STE 203
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4422
Country	:	US
Telephone Number	:	915-726-2175
Fax Number	:

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

Provider Enumeration Date	:	07/18/2005
Last Update Date	:	12/10/2025

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Directions to “ MANUEL F VALENZUELA MD” Practice Location

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