Provider Demographics
NPI:1194735605
Name:VALERA, LUIS F (DC)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:F
Last Name:VALERA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4680 S EASTERN AVE STE E
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6192
Mailing Address - Country:US
Mailing Address - Phone:702-598-0500
Mailing Address - Fax:
Practice Address - Street 1:4680 S EASTERN AVE STE E
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6192
Practice Address - Country:US
Practice Address - Phone:702-598-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01178111N00000X
CA12565111N00000X
FLCH4388111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV20-2952462OtherTAX ID NUMBER