Basic Information
| Provider Information | |||||||||
| NPI: | 1831506179 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VALDES | ||||||||
| FirstName: | EDUARDO | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3247 DAWES DR | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752115760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143307767 | ||||||||
| FaxNumber: | 2143307780 | ||||||||
| Practice Location | |||||||||
| Address1: | 3247 DAWES DR | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752115760 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143307767 | ||||||||
| FaxNumber: | 2143307780 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2014 | ||||||||
| LastUpdateDate: | 08/03/2017 | ||||||||
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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 | 207Q00000X | 32,654-R | PR | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 31,668-R | PR | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 13640-I | PR | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | R1665 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.