Provider Demographics
NPI:1235101106
Name:VALAVALKAR, SUBHASHINI S (MD)
Entity Type:Individual
Prefix:MRS
First Name:SUBHASHINI
Middle Name:S
Last Name:VALAVALKAR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:333 N SANTA ROSA ST
Mailing Address - Street 2:SUITE D4023
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-3108
Mailing Address - Country:US
Mailing Address - Phone:469-282-2711
Mailing Address - Fax:469-282-2609
Practice Address - Street 1:11503 NW MILITARY HWY
Practice Address - Street 2:STE 113
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1884
Practice Address - Country:US
Practice Address - Phone:210-705-5151
Practice Address - Fax:210-853-1540
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2016-09-17
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Provider Licenses
StateLicense IDTaxonomies
KY37325208000000X
TXN7595208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65936305Medicaid
TX2203614Medicaid
TX220361406Medicaid
KY64067515Medicaid
KY65936305Medicaid