Provider Demographics
NPI:1194999433
Name:VALDES, CAROLINE LEILANI (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:LEILANI
Last Name:VALDES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:CAROLINE
Other - Middle Name:LEILANI
Other - Last Name:GIETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 AIRPARK CENTER DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217-5200
Mailing Address - Country:US
Mailing Address - Phone:615-221-4400
Mailing Address - Fax:
Practice Address - Street 1:2710 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5701
Practice Address - Country:US
Practice Address - Phone:310-962-4637
Practice Address - Fax:361-573-5042
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA94289207ND0900X, 207ZP0102X
TXM8399207ZP0102X
CAA94224207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology