Provider Demographics
NPI:1386640753
Name:VEVE, ISIDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ISIDRA
Middle Name:
Last Name:VEVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 N CARROLL AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6455
Mailing Address - Country:US
Mailing Address - Phone:817-442-1250
Mailing Address - Fax:
Practice Address - Street 1:410 N CARROLL AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6455
Practice Address - Country:US
Practice Address - Phone:817-442-1250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2014-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7726207L00000X
NYNY1666-57207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B53651Medicare UPIN
NY9L1921Medicare ID - Type Unspecified