Provider Demographics
NPI:1962431353
Name:VALDEZ, LUIS ALBERTO (RN, MSN, FNP-BC)
Entity type:Individual
Prefix:MR
First Name:LUIS
Middle Name:ALBERTO
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:RN, MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 PAPPAS ST
Mailing Address - Street 2:LAREDO TEXAS 78041
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-1705
Mailing Address - Country:US
Mailing Address - Phone:956-795-8100
Mailing Address - Fax:956-718-6294
Practice Address - Street 1:1515 PAPPAS ST
Practice Address - Street 2:LAREDO TEXAS 78041
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-1705
Practice Address - Country:US
Practice Address - Phone:956-795-8100
Practice Address - Fax:956-718-6294
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX607163363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX607163OtherLICENSE
TX164722403Medicaid
TX164722403Medicaid
TX451961Medicare Oscar/Certification
TX451838Medicare Oscar/Certification
TX081896501Medicaid
TX164722401Medicaid
TX164722402OtherCSHCN
TXQ10285Medicare UPIN
TX451960Medicare Oscar/Certification
TX451841Medicare Oscar/Certification
TX8B5351Medicare PIN