Federico Valderrama-Bazan, M.D.,P.a.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E3488 Issued in TX

Legal business name

FEDERICO VALDERRAMA-BAZAN, M.D.,P.A.

Practice address

810 Hospital Dr
Suite 320
Beaumont, TX 77701-4600

Phone

(409) 839-4757

Fax

(409) 839-4294

NPI assigned

Nov 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Federico Valderrama-Bazan, M.D.

Title

President

Phone

(409) 839-4757

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285286400000",
    "number": "1366517088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 HOSPITAL DR",
            "address_2": "SUITE 320",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014600",
            "telephone_number": "409-839-4757",
            "fax_number": "409-839-4294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 HOSPITAL DR",
            "address_2": "SUITE 320",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777014600",
            "telephone_number": "409-839-4757",
            "fax_number": "409-839-4294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDERICO VALDERRAMA-BAZAN, M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2010-09-24",
        "status": "A",
        "authorized_official_last_name": "VALDERRAMA-BAZAN",
        "authorized_official_first_name": "FEDERICO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "409-839-4757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E3488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123414807",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "172224101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Omer Farooq, M.D
• Christina Farrell, DC
• Mark Fasulo, MD
• William Arthur Fawcett IV, MD
• Amy Featherston, NP
• Bryan Fedor, PTA
• John Fehrenbacher
• Feldschau & Co, PLLC
• Charles Ray Ferguson Jr., DDS
• Fernando E Silva, MD, PA

• Family Medicine Physician in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.