Provider Demographics
NPI:1578504049
Name:VALENA, NELSON V (MD)
Entity Type:Individual
Prefix:DR
First Name:NELSON
Middle Name:V
Last Name:VALENA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 CRAWFORD ST
Mailing Address - Street 2:300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8942
Mailing Address - Country:US
Mailing Address - Phone:713-861-2022
Mailing Address - Fax:713-861-2234
Practice Address - Street 1:2101 CRAWFORD ST
Practice Address - Street 2:300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8942
Practice Address - Country:US
Practice Address - Phone:713-861-2022
Practice Address - Fax:713-861-2234
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5206225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102758302Medicaid
8239K0Medicare ID - Type Unspecified
G38174Medicare UPIN