Provider Demographics
NPI:1154982486
Name:VALDEZ, BLESSIE MAE (PA-C)
Entity type:Individual
Prefix:
First Name:BLESSIE
Middle Name:MAE
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8811 SIENNA SPRINGS BLVD APT 2126
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-7336
Mailing Address - Country:US
Mailing Address - Phone:281-844-1409
Mailing Address - Fax:
Practice Address - Street 1:1201 CREEK WAY DR STE C
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4568
Practice Address - Country:US
Practice Address - Phone:281-302-6636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA128872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry