Provider Demographics
NPI:1316123466
Name:VALDEZ, ISABEL (PA)
Entity type:Individual
Prefix:MISS
First Name:ISABEL
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2911 S SHORE BLVD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3922
Mailing Address - Country:US
Mailing Address - Phone:281-538-8188
Mailing Address - Fax:281-538-8189
Practice Address - Street 1:2911 S SHORE BLVD
Practice Address - Street 2:SUITE 190
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3922
Practice Address - Country:US
Practice Address - Phone:281-538-8188
Practice Address - Fax:281-538-8189
Is Sole Proprietor?:No
Enumeration Date:2008-01-18
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363A00000X363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant