Provider Demographics
NPI:1326225400
Name:VEAZEY, CONNIE S (PHD)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:S
Last Name:VEAZEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21903 VENTURE PARK DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-5202
Mailing Address - Country:US
Mailing Address - Phone:832-595-4641
Mailing Address - Fax:
Practice Address - Street 1:21903 VENTURE PARK DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-5202
Practice Address - Country:US
Practice Address - Phone:832-595-4641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36025103TC0700X
LA1027103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical