Individual
VALERIE A AGENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107
(817) 735-2200
Mailing address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2709
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M2526
TX
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
M2526
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182440010
—
TX
05
—
182440102
—
TX
05
—
182440105
—
TX
01
—
M2526
TEXAS MEDICAL BOARD
TX
Enumeration date
07/14/2006
Last updated
02/13/2019
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