Provider Demographics
NPI:1023128998
Name:VALDES, LUIS ANTERO (PHD)
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:ANTERO
Last Name:VALDES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3926 BAHLER AVE
Mailing Address - Street 2:
Mailing Address - City:MANUEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578
Mailing Address - Country:US
Mailing Address - Phone:281-489-1290
Mailing Address - Fax:281-489-8806
Practice Address - Street 1:2225 CR 90 STE 215
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581
Practice Address - Country:US
Practice Address - Phone:281-412-6863
Practice Address - Fax:281-412-6863
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25081103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist