Organization Active NPI

Paul L Valenza

  • Podiatrist
  • Kerrville, TX
National Provider Identifier
1104095645
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0997 Issued in TX
Legal business name
PAUL L VALENZA
Practice address
316 W Water St
Kerrville, TX 78028-4242
Phone
(830) 895-7788
Fax
(830) 895-7794
NPI assigned
Feb 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Paul Valenza, DPM
Title
Owner
Phone
(830) 895-7788

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 0997 TX Primary

Addresses

Primary practice location

316 W Water St
Kerrville, TX 78028-4242

Mailing address

316 W Water St
Kerrville, TX 78028-4242
Phone (830) 895-7788

Other identifiers 1

IdentifierTypeStateIssuer
018751001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930030407 TX DME Supplier - Physician - Podiatry 1951429422 Practice locations: Kerrville, TX

National Provider Directory

National Provider Directory

Locations

316 W Water St
Kerrville, TX 78028
Phone (830) 895-3733

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1104095645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 W WATER ST",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780284242",
            "telephone_number": "830-895-7788",
            "fax_number": "830-895-7794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 W WATER ST",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780284242",
            "telephone_number": "830-895-7788",
            "fax_number": "830-895-7794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL L VALENZA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "VALENZA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "830-895-7788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "0997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018751001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kerrville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.