Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP144856 | TX |
NPI | 1003447863 |
---|---|
Provider Name | Mayra Valdez |
First Address | Houston, TX 77049-1375 |
Second Address | Baytown, TX 77521-2122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2020 |
Last Update Date | 30/01/2020 |