Provider Demographics
NPI:1740233790
Name:VALDEZ, CRISTINA VIRGINA (MD)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:VIRGINA
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 N MACARTHUR BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-3675
Mailing Address - Country:US
Mailing Address - Phone:972-256-3700
Mailing Address - Fax:866-630-6348
Practice Address - Street 1:3501 N MACARTHUR BLVD STE 400
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-3649
Practice Address - Country:US
Practice Address - Phone:972-594-0100
Practice Address - Fax:972-594-0111
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9410207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1668337 01Medicaid
TX035990303Medicaid
751365258OtherTAX ID
TXG13140Medicare UPIN
TX8J6040Medicare PIN
751365258OtherTAX ID