Provider Demographics
NPI:1467637132
Name:VICTORIANO VALDEZ M.D. P.A.
Entity Type:Organization
Organization Name:VICTORIANO VALDEZ M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-773-5000
Mailing Address - Street 1:PO BOX 7130
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78853-7130
Mailing Address - Country:US
Mailing Address - Phone:830-773-5000
Mailing Address - Fax:830-773-6262
Practice Address - Street 1:1951 N VETERANS BLVD
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-4476
Practice Address - Country:US
Practice Address - Phone:830-773-5000
Practice Address - Fax:830-773-6262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115301701Medicaid
TX115301701Medicaid