Provider Demographics
NPI:1710965975
Name:VELA, ROBERT (MD,PA)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:VELA
Suffix:
Gender:M
Credentials:MD,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 CLEO ST # A
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-1914
Mailing Address - Country:US
Mailing Address - Phone:361-991-3729
Mailing Address - Fax:
Practice Address - Street 1:2201 CLEO ST
Practice Address - Street 2:SUITE A
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1914
Practice Address - Country:US
Practice Address - Phone:361-888-4960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8993174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0348310-01Medicaid
TX00MA53Medicare ID - Type Unspecified
TX0348310-01Medicaid