Provider Demographics
NPI:1225799703
Name:VELA-JASSO, SARAH VICTORIA (PA-C)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:VICTORIA
Last Name:VELA-JASSO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 ELIZABETH ST STE 804
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2231
Mailing Address - Country:US
Mailing Address - Phone:361-902-4343
Mailing Address - Fax:361-902-6000
Practice Address - Street 1:613 ELIZABETH ST STE 804
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2231
Practice Address - Country:US
Practice Address - Phone:361-902-4343
Practice Address - Fax:361-902-6000
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA15085363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant