Individual ProviderIrene ValdiviaPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4206 Retama Cir, Victoria, TX 77901-2765(361) 582-0611PECOS EnrollmentBased on the most recent information from CMS, provider Irene Valdivia does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1831402247Provider TypeIndividualFull NameValdivia, IreneCredentialDPTGenderFemaleSole ProprietorNoEnumeration Date7/15/2010Last Updated5/16/2014Contact InformationPractice LocationPractice Address4206 Retama Cir, Victoria, TX 77901-2765Phone(361) 582-0611FaxUnlisted FaxMailing LocationMailing AddressPO Box 5171, Victoria, TX 77903-5171PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense1198026Texas