Provider Demographics
NPI:1578916797
Name:VALDEZ, MARGARET E (PTA)
Entity Type:Individual
Prefix:MISS
First Name:MARGARET
Middle Name:E
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:MRS
Other - First Name:MARGARET
Other - Middle Name:VALDEZ
Other - Last Name:NAVARRETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:1492 CALLE CIELO VIS
Mailing Address - Street 2:
Mailing Address - City:BERNALILLO
Mailing Address - State:NM
Mailing Address - Zip Code:87004-9147
Mailing Address - Country:US
Mailing Address - Phone:505-818-3869
Mailing Address - Fax:
Practice Address - Street 1:5200 COPPER AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1473
Practice Address - Country:US
Practice Address - Phone:505-266-5557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-1124225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant