Provider Demographics
NPI:1972914455
Name:VALDEZ, ALYSSA MARIEL (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIEL
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
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Mailing Address - Street 1:2280 TRAWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3020
Mailing Address - Country:US
Mailing Address - Phone:915-595-3535
Mailing Address - Fax:915-595-3922
Practice Address - Street 1:4242 HONDO PASS DR
Practice Address - Street 2:STE,110
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79904-1205
Practice Address - Country:US
Practice Address - Phone:915-751-0595
Practice Address - Fax:915-751-0599
Is Sole Proprietor?:No
Enumeration Date:2014-05-19
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1240446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist