Basic Information
| Provider Information | |||||||||
| NPI: | 1467845768 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VALDEZ | ||||||||
| FirstName: | OLIVER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 GRANDE OAK BLVD APT 207 | ||||||||
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| City: | SARALAND | ||||||||
| State: | AL | ||||||||
| PostalCode: | 365713717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2512146980 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1210 E 8TH ST STE 1 | ||||||||
| Address2: | |||||||||
| City: | WESLACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785967120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566874560 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2015 | ||||||||
| LastUpdateDate: | 03/10/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PTH7386 | AL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.