Individual
DR. MARIO VALENCIA JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2829 4TH AVE STE 150, LAKE CHARLES, LA 70601-7897
(337) 480-7800
(337) 474-4552
Mailing address
PO BOX 123977 DEPT 3977, DALLAS, TX 75312-3977
(337) 494-2921
(337) 494-6523
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
309286
LA
2084P0800X
Psychiatry Physician
ME130637
FL
2084P0800X
Psychiatry Physician
TRN 20218
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2476572
—
LA
Enumeration date
03/29/2016
Last updated
05/12/2022
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