Provider Demographics
NPI:1780012112
Name:WINFREY, VALERIE (OD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:WINFREY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:DELEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:7400 SAN PEDRO AVE
Mailing Address - Street 2:SUITE486
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5399
Mailing Address - Country:US
Mailing Address - Phone:210-541-0008
Mailing Address - Fax:
Practice Address - Street 1:7400 SAN PEDRO AVE
Practice Address - Street 2:SUITE486
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5399
Practice Address - Country:US
Practice Address - Phone:210-541-0008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-22
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8252TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist