Provider Demographics
NPI:1225445984
Name:VELA, FARYN KAYE (DDS)
Entity Type:Individual
Prefix:DR
First Name:FARYN
Middle Name:KAYE
Last Name:VELA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 WEST END ST
Mailing Address - Street 2:PO BOX 2
Mailing Address - City:GOLIAD
Mailing Address - State:TX
Mailing Address - Zip Code:77963
Mailing Address - Country:US
Mailing Address - Phone:361-649-6699
Mailing Address - Fax:
Practice Address - Street 1:411 E HIGHWAY 123
Practice Address - Street 2:
Practice Address - City:KARNES CITY
Practice Address - State:TX
Practice Address - Zip Code:78118-3015
Practice Address - Country:US
Practice Address - Phone:361-649-6699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30111122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist