Provider Demographics
NPI:1235204173
Name:VELEY, EUGENE A (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:A
Last Name:VELEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GENE
Other - Middle Name:A
Other - Last Name:VELEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:115 WENDOVER CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-8589
Mailing Address - Country:US
Mailing Address - Phone:347-886-9433
Mailing Address - Fax:682-688-7744
Practice Address - Street 1:1643 LANCASTER DR STE 205
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3593
Practice Address - Country:US
Practice Address - Phone:817-886-8552
Practice Address - Fax:682-688-7744
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232772207RP1001X
TXP3093207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGMedicaid
PA1019432100001Medicaid
PA1967484OtherBLUE SHIELD
NY00246075Medicaid
TXPENDINGOtherBCBSTX