Basic Information
Provider Information
NPI: 1114186152
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DE VALDENEBRO
FirstName: ASHLEY PAIGE
MiddleName: RIOUX
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2000 E LAMAR BLVD STE 400
Address2:  
City: ARLINGTON
State: TX
PostalCode: 760067353
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 2222 WELBORN ST
Address2:  
City: DALLAS
State: TX
PostalCode: 752193924
CountryCode: US
TelephoneNumber: 2145595000
FaxNumber: 2144437309
Other Information
ProviderEnumerationDate: 06/05/2008
LastUpdateDate: 06/29/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XP2848TXY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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