Provider Demographics
NPI:1770634115
Name:DALLAS VETERANS AFFAIRS MEDICAL CENTER
Entity Type:Organization
Organization Name:DALLAS VETERANS AFFAIRS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ-REYNA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:214-857-0497
Mailing Address - Street 1:1713 WALNUT HILL DR
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088-1552
Mailing Address - Country:US
Mailing Address - Phone:214-284-4112
Mailing Address - Fax:
Practice Address - Street 1:1401 W JEFFERSON BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-5326
Practice Address - Country:US
Practice Address - Phone:214-415-3804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX573378282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital