Provider Demographics
NPI:1487858171
Name:LEBRON VALDEZ, RICARDO A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICARDO
Middle Name:A
Last Name:LEBRON VALDEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RICARDO
Other - Middle Name:ARTURO
Other - Last Name:LEBRON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:9101 LBJ FWY
Mailing Address - Street 2:SUITE 710
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2057
Mailing Address - Country:US
Mailing Address - Phone:469-939-5298
Mailing Address - Fax:
Practice Address - Street 1:929 N GALLOWAY AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-2476
Practice Address - Country:US
Practice Address - Phone:972-285-4844
Practice Address - Fax:972-285-4834
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN0915208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery