1144722844 NPI number — JOSE RAFAEL VALDEZ FNP-C, ENP, MSN

Table of content: JOSE RAFAEL VALDEZ FNP-C, ENP, MSN (NPI 1144722844)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144722844 NPI number — JOSE RAFAEL VALDEZ FNP-C, ENP, MSN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VALDEZ
Provider First Name:
JOSE
Provider Middle Name:
RAFAEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-C, ENP, MSN
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CEPIN
Provider Other First Name:
JOSE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144722844
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/08/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2028 WIRT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77055-1602
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-682-7066
Provider Business Mailing Address Fax Number:
832-916-2813

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2028 WIRT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77055-1602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-682-7066
Provider Business Practice Location Address Fax Number:
832-916-2813
Provider Enumeration Date:
03/08/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP136427 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com