Provider Demographics
NPI:1790251031
Name:ALCALA, VALARIE RAMIREZ (PA-C)
Entity Type:Individual
Prefix:
First Name:VALARIE
Middle Name:RAMIREZ
Last Name:ALCALA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4707 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-4515
Mailing Address - Country:US
Mailing Address - Phone:325-277-3629
Mailing Address - Fax:
Practice Address - Street 1:5615 DEAUVILLE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79706-3154
Practice Address - Country:US
Practice Address - Phone:432-221-4708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-14
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTEMPORARY363AM0700X
TXPA12415363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical