Provider Demographics
NPI:1184689903
Name:VALDEZ, ALICIA VARA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:VARA
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:98 BRIGGS ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1286
Mailing Address - Country:US
Mailing Address - Phone:210-927-9500
Mailing Address - Fax:210-927-9200
Practice Address - Street 1:98 BRIGGS ST
Practice Address - Street 2:SUITE 800
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1286
Practice Address - Country:US
Practice Address - Phone:210-927-9500
Practice Address - Fax:210-927-9200
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL1770207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142789001Medicaid
TX142789001Medicaid
TX8F3733Medicare PIN