Individual
DR. CHARLES TAYLOR VALADIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
903 W MARTIN ST # MS 49-2, SAN ANTONIO, TX 78207-0903
(210) 358-0572
Mailing address
8904 FOREST BREEZE DR, CORDOVA, TN 38018-7685
(901) 336-9187
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
T1868
TX
390200000X
Student in an Organized Health Care Education/Training Program
BP10063267
TX
Other
Enumeration date
04/20/2018
Last updated
03/18/2024
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