Provider Demographics
NPI:1780286260
Name:VALDEZ, LUIS JAVIER (APRN-CNP)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:JAVIER
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5007 RIVER KENTON
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-5418
Mailing Address - Country:US
Mailing Address - Phone:830-370-2578
Mailing Address - Fax:
Practice Address - Street 1:5007 RIVER KENTON
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-5418
Practice Address - Country:US
Practice Address - Phone:830-370-2578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1018558363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health