Provider Demographics
NPI:1699154112
Name:BEDSOLE, VALERIE GRANT (MD)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:GRANT
Last Name:BEDSOLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:CHRISTINE
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3551 ROGER BROOKE DR
Mailing Address - Street 2:SAMMC, MCHE-MDX, INTERNAL MEDICINE RESIDENCY
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4504
Mailing Address - Country:US
Mailing Address - Phone:210-916-8176
Mailing Address - Fax:210-292-7868
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:SAMMC, MCHE-MDX, INTERNAL MEDICINE RESIDENCY
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-8176
Practice Address - Fax:210-292-7868
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2017-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101261620208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice