Individual
EDER VALENZUELA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8537 SUSSEX CT, FORT WORTH, TX 76108-2729
(817) 600-2752
Mailing address
8537 SUSSEX CT, FORT WORTH, TX 76108-2729
(817) 600-2752
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
331388
TX
Other
Enumeration date
04/09/2018
Last updated
04/09/2018
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