Provider Demographics
NPI:1144292467
Name:VALLES-LEBRON, NORMA M (MD)
Entity type:Individual
Prefix:MS
First Name:NORMA
Middle Name:M
Last Name:VALLES-LEBRON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NORMA
Other - Middle Name:M
Other - Last Name:VALLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2455 NE LOOP 410
Mailing Address - Street 2:STE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5649
Mailing Address - Country:US
Mailing Address - Phone:210-599-6000
Mailing Address - Fax:210-657-5586
Practice Address - Street 1:2455 NE LOOP 410
Practice Address - Street 2:STE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5649
Practice Address - Country:US
Practice Address - Phone:210-599-6000
Practice Address - Fax:210-657-5586
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9924208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0963084-06OtherWELLMED MEDICAID
TXK9924OtherSTATE LICENSE
TX096308404Medicaid
TXTXB151200OtherWELLMED MEDICARE
TX096308404Medicaid
TXK9924OtherSTATE LICENSE