Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 37107 | AZ |
N | 2080P0202X | Pediatric Cardiologist | ME106598 | FL |
NPI | 1053517532 |
---|---|
Provider Name | Santiago O Valdes |
First Address | Houston, TX 77046-0207 |
Second Address | Houston, TX 77030-2608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2007 |
Last Update Date | 16/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
987654 | (05) | AZ |
D12345 | (02) | AZ |