Provider Demographics
NPI:1619064870
Name:VICTOR D. VELA, M.D., P.A.
Entity Type:Organization
Organization Name:VICTOR D. VELA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-816-6844
Mailing Address - Street 1:1201 S MAIN ST
Mailing Address - Street 2:SUITE 114
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2833
Mailing Address - Country:US
Mailing Address - Phone:830-816-6844
Mailing Address - Fax:830-816-6922
Practice Address - Street 1:1201 S MAIN ST
Practice Address - Street 2:SUITE 114
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2833
Practice Address - Country:US
Practice Address - Phone:830-816-6844
Practice Address - Fax:830-816-6922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7904207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty