Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | L2721 | TX |
NPI | 1104800200 |
---|---|
Provider Name | Marcos J. Valdez |
First Address | Corpus Christi, TX 78411-1721 |
Second Address | Corpus Christi, TX 78411-1721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2005 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
162071804 | (05) | TX |
H99422 | (02) | TX |