Provider Demographics
NPI:1679521694
Name:VELA, JOSE ALBERTO
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:ALBERTO
Last Name:VELA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1242 E. HWY BUS 83
Mailing Address - Street 2:#7
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-4346
Mailing Address - Country:US
Mailing Address - Phone:956-821-2886
Mailing Address - Fax:956-583-2714
Practice Address - Street 1:1242 E. HWY BUS 83
Practice Address - Street 2:#7
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-4346
Practice Address - Country:US
Practice Address - Phone:956-821-2886
Practice Address - Fax:956-583-2714
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX41023183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180568101Medicaid