Provider Demographics
NPI:1356550313
Name:OLIVIA A VALDEZ, M.D., P.A.
Entity type:Organization
Organization Name:OLIVIA A VALDEZ, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:VALDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-229-9085
Mailing Address - Street 1:202 HILL COUNTRY LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2906
Mailing Address - Country:US
Mailing Address - Phone:210-229-9085
Mailing Address - Fax:210-354-4750
Practice Address - Street 1:202 HILL COUNTRY LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2906
Practice Address - Country:US
Practice Address - Phone:210-229-9085
Practice Address - Fax:210-354-4750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG79222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX079886001Medicaid
TX00101ROtherBLUE CROSS BLUE SHIELD
TX079886001Medicaid