Provider Demographics
NPI:1043772361
Name:VELASCO, SANDRA LUZ (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LUZ
Last Name:VELASCO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:1810 MURCHISON DR STE 50
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2927
Mailing Address - Country:US
Mailing Address - Phone:915-857-4130
Mailing Address - Fax:915-857-4135
Practice Address - Street 1:1810 MURCHISON DR STE 50
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2927
Practice Address - Country:US
Practice Address - Phone:915-857-4130
Practice Address - Fax:915-857-4135
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP140991363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner