Provider Demographics
NPI:1033307749
Name:VALDEZ, JOE
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1779 WELLS BRANCH PKWY #110 B - PMB 363
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78728
Mailing Address - Country:US
Mailing Address - Phone:512-784-0313
Mailing Address - Fax:512-692-1941
Practice Address - Street 1:1779 WELLS BRANCH PKWY #110 B - PMB 363
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728
Practice Address - Country:US
Practice Address - Phone:512-784-0313
Practice Address - Fax:512-692-1941
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications