Provider Demographics
NPI:1982704565
Name:VALDEZ, MARIA MACIAS (PAC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:MACIAS
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 COMMERCE ST
Mailing Address - Street 2:STE. 700
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-1826
Mailing Address - Country:US
Mailing Address - Phone:615-913-5086
Mailing Address - Fax:
Practice Address - Street 1:2425 WEST LOOP S STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-4208
Practice Address - Country:US
Practice Address - Phone:615-913-5086
Practice Address - Fax:888-494-2588
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01990363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2310115OtherUNITED HEALTHCARE
TX321389401Medicaid
TX8L8919Medicare Oscar/Certification
TX2310115OtherUNITED HEALTHCARE