Individual
TIFFANI VALDEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1105 W CHURCH ST, LIVINGSTON, TX 77351-3016
(936) 327-3818
Mailing address
1105 W CHURCH ST, LIVINGSTON, TX 77351-3016
(936) 327-3818
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
80213
TX
Other
Enumeration date
10/21/2014
Last updated
10/21/2014
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