Provider Demographics
NPI:1497027270
Name:FELAU, VILSON (MD)
Entity Type:Individual
Prefix:DR
First Name:VILSON
Middle Name:
Last Name:FELAU
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 1:1121 SANDPIPER AVE
Mailing Address - Street 2:APT. # 29
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3157
Mailing Address - Country:US
Mailing Address - Phone:956-784-4718
Mailing Address - Fax:
Practice Address - Street 1:AMPLIACION ADOLFO LOPEZ MATEUS S/N
Practice Address - Street 2:
Practice Address - City:REYNOSA
Practice Address - State:TAMAULIPAS
Practice Address - Zip Code:88560
Practice Address - Country:MX
Practice Address - Phone:956-784-4718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ4558026208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice