Provider Demographics
NPI:1245738376
Name:VALENCIA, VICTOR MANUEL JR
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:MANUEL
Last Name:VALENCIA
Suffix:JR
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 1:13800 FM 498
Mailing Address - Street 2:
Mailing Address - City:LYFORD
Mailing Address - State:TX
Mailing Address - Zip Code:78569-2239
Mailing Address - Country:US
Mailing Address - Phone:956-349-2031
Mailing Address - Fax:
Practice Address - Street 1:13800 FM 498 #80
Practice Address - Street 2:
Practice Address - City:LYFORD
Practice Address - State:TX
Practice Address - Zip Code:78569-6500
Practice Address - Country:US
Practice Address - Phone:956-349-2031
Practice Address - Fax:956-349-2033
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant