Provider Demographics
NPI:1497704357
Name:VELASCO, MARIA CHRISTINA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CHRISTINA
Last Name:VELASCO
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 1:601 E SAN ANTONIO ST
Mailing Address - Street 2:STE. 503W
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-6004
Mailing Address - Country:US
Mailing Address - Phone:361-575-3775
Mailing Address - Fax:361-575-3742
Practice Address - Street 1:601 E SAN ANTONIO ST
Practice Address - Street 2:STE. 503W
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6004
Practice Address - Country:US
Practice Address - Phone:361-575-3775
Practice Address - Fax:361-575-3742
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6734207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096574102Medicaid
TX8574K1Medicare PIN