Provider Demographics
NPI:1508591736
Name:VELA, ALESANDRA
Entity Type:Individual
Prefix:
First Name:ALESANDRA
Middle Name:
Last Name:VELA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10B 3RD ST W # 826B
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-5746
Mailing Address - Country:US
Mailing Address - Phone:731-446-3781
Mailing Address - Fax:
Practice Address - Street 1:10B 3RD ST W # 826B
Practice Address - Street 2:
Practice Address - City:UNIVERSAL CITY
Practice Address - State:TX
Practice Address - Zip Code:78148-5746
Practice Address - Country:US
Practice Address - Phone:731-446-3781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians