Provider Demographics
NPI:1780128587
Name:PEINADO REYES, VALERY (PA-C)
Entity type:Individual
Prefix:MISS
First Name:VALERY
Middle Name:
Last Name:PEINADO REYES
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 1:3600 GASTON AVE STE 502
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1805
Mailing Address - Country:US
Mailing Address - Phone:469-800-7700
Mailing Address - Fax:469-800-7710
Practice Address - Street 1:3600 GASTON AVE STE 502
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1805
Practice Address - Country:US
Practice Address - Phone:469-800-7700
Practice Address - Fax:469-800-7710
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AS0400X
TXPA11060363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical