Provider Demographics
NPI:1134467483
Name:VALDES, YOLANDA L (PA)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:L
Last Name:VALDES
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:3110 NOGALITOS
Mailing Address - Street 2:105
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78225-2336
Mailing Address - Country:US
Mailing Address - Phone:210-533-0257
Mailing Address - Fax:210-531-9488
Practice Address - Street 1:2 SPURS LN BLDG 6
Practice Address - Street 2:100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1760
Practice Address - Country:US
Practice Address - Phone:210-561-8169
Practice Address - Fax:210-561-8178
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2015-10-07
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Provider Licenses
StateLicense IDTaxonomies
TXPA08120363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA08120OtherSTATE LICENSE