Provider Demographics
NPI:1568755155
Name:VELA, VICTORIA AMELIA (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:AMELIA
Last Name:VELA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 CANOGA PARK DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78245-1112
Mailing Address - Country:US
Mailing Address - Phone:210-204-4874
Mailing Address - Fax:
Practice Address - Street 1:202 CANOGA PARK DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78245
Practice Address - Country:US
Practice Address - Phone:210-204-4874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP120280367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX283383210OtherCSHCN
TX283383209Medicaid