Provider Demographics
NPI:1619915907
Name:VALLE, JOSE JULIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:JULIAN
Last Name:VALLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 254
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78291-0254
Mailing Address - Country:US
Mailing Address - Phone:210-621-0640
Mailing Address - Fax:210-621-2386
Practice Address - Street 1:7940 FLOYD CURL DR
Practice Address - Street 2:SUITE 1030
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3905
Practice Address - Country:US
Practice Address - Phone:210-621-0640
Practice Address - Fax:210-621-2386
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3102207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI42199Medicare UPIN
TXM3102OtherTEX MED LIC