Provider Demographics
NPI:1477561421
Name:VELOX, ANDREA JEAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:JEAN
Last Name:VELOX
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:PO BOX 630456
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77263-0456
Mailing Address - Country:US
Mailing Address - Phone:281-431-0896
Mailing Address - Fax:
Practice Address - Street 1:5959 WEST LOOP S
Practice Address - Street 2:440
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2421
Practice Address - Country:US
Practice Address - Phone:832-455-4086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18326101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1676991-03Medicaid
TX01265693OtherAMERIGROUP
TX10034585OtherAMERIGROUP PRACTITIONER #