Provider Demographics
NPI:1588645170
Name:LIAO, VALERIE L (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:L
Last Name:LIAO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:LAUREL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7777 FOREST LN STE A331
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2538
Mailing Address - Country:US
Mailing Address - Phone:972-566-2886
Mailing Address - Fax:214-723-5671
Practice Address - Street 1:7777 FOREST LN STE A331
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2538
Practice Address - Country:US
Practice Address - Phone:972-566-2886
Practice Address - Fax:214-723-5671
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
TXJ6539207RI0200X, 207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No174400000XOther Service ProvidersSpecialist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151730201Medicaid
TX8352M3Medicare PIN
TXY58450Medicare UPIN