Provider Demographics
NPI:1831506179
Name:VALDES, EDUARDO (MD)
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:VALDES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E 7TH ST STE 700
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-3218
Mailing Address - Country:US
Mailing Address - Phone:737-707-3909
Mailing Address - Fax:
Practice Address - Street 1:306 S. HAMPTON RD.
Practice Address - Street 2:SUITE 322
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208
Practice Address - Country:US
Practice Address - Phone:469-501-9205
Practice Address - Fax:469-629-1179
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR32,654-R207Q00000X
PR31,668-R207Q00000X
PR13640-I207Q00000X
TXR1665207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine