Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | D74773 | MD |
N | 208600000X | Surgeon | D74773 | MD |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 326457 | LA |
NPI | 1104055128 |
---|---|
Provider Name | Dr. Vicente Valero III |
First Address | New Orleans, LA 70115-3768 |
Second Address | Aurora, CO 80045-2527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2009 |
Last Update Date | 22/06/2021 |