Provider Demographics
NPI:1568610038
Name:VANESSA L VELA MARTINEZ M.D.
Entity Type:Organization
Organization Name:VANESSA L VELA MARTINEZ M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VELA MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-495-4888
Mailing Address - Street 1:2218 SAWGRASS RDG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-7237
Mailing Address - Country:US
Mailing Address - Phone:210-685-9900
Mailing Address - Fax:210-495-1333
Practice Address - Street 1:525 OAK CENTRE DR
Practice Address - Street 2:STE 170
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3944
Practice Address - Country:US
Practice Address - Phone:210-495-4888
Practice Address - Fax:210-495-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL59992084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI25806Medicare UPIN