Provider Demographics
NPI:1235101221
Name:VELA, CARLOS C (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:C
Last Name:VELA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3226 W ALBERTA RD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9635
Mailing Address - Country:US
Mailing Address - Phone:956-566-3860
Mailing Address - Fax:
Practice Address - Street 1:3002 SANTA ALEJANDRA
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-7551
Practice Address - Country:US
Practice Address - Phone:956-566-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6393207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096743203Medicaid
TXP00253395OtherRAILROAD MEDICARE
TX8U5316OtherBLUE CROSS
TX096743203Medicaid
TX8F0657Medicare PIN