Luis Omar Valdivieso Jr., PHARM.D.

Primary specialty

Nutrition Support PharmacistTaxonomy code 1835N1003X

License

42791 Issued in TX

Practice address

2100 Berqguire Rd Ste No. 1
San Antonio, TX 78236

Phone

(210) 292-2453

NPI assigned

Dec 1, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881762300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13116 MYSTIC SADDLE",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780233985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 BERQGUIRE RD STE NO. 1",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78236",
            "telephone_number": "210-292-2453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALDIVIESO",
        "first_name": "LUIS",
        "middle_name": "OMAR",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "TX",
            "license": "42791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yaritza Valdez
• Yolanda J. Valdez, LMSW
• Valdez2009,Inc.
• Blanca Rosa Valdillez
• Mayra Valdivia Carlisle, DO
• Kandy Luxely Valdovinos, OD
• Kaylynn Dawn Vale, OTR/L, OTD
• Sandra D Vale, MD
• Joseph Dean Valek, CCP
• Valen Mental Health Services PLLC

• Pharmacist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pharmacist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.