Basic Information
| Provider Information | |||||||||
| NPI: | 1609375625 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VALENTINO FERNANDES MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13737 NOEL RD STE 1400 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752402004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2142171911 | ||||||||
| FaxNumber: | 2142171901 | ||||||||
| Practice Location | |||||||||
| Address1: | 12200 PARK CENTRAL DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752512124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1491907572 | ||||||||
| FaxNumber: | 2142171901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2018 | ||||||||
| LastUpdateDate: | 05/06/2019 | ||||||||
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| AuthorizedOfficialLastName: | FERNANDES | ||||||||
| AuthorizedOfficialFirstName: | VALENTINO | ||||||||
| AuthorizedOfficialMiddleName: | FRANCIS JOSEPH | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2146777227 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | L7375 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.