Provider Demographics
NPI:1184285199
Name:VALDEZ, LIZETT ANALY
Entity type:Individual
Prefix:
First Name:LIZETT
Middle Name:ANALY
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 JAIME J ZAPATA AVE UNIT 10B
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-5944
Mailing Address - Country:US
Mailing Address - Phone:956-404-7600
Mailing Address - Fax:
Practice Address - Street 1:4315 JAIME J ZAPATA AVE UNIT 10B
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-5944
Practice Address - Country:US
Practice Address - Phone:956-404-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX344779164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse