Provider Demographics
NPI:1790733327
Name:VELA, ANGELA (MD)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:VELA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 N KING ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-4801
Mailing Address - Country:US
Mailing Address - Phone:830-372-4891
Mailing Address - Fax:830-379-3096
Practice Address - Street 1:1255 ASHBY ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5118
Practice Address - Country:US
Practice Address - Phone:830-379-9391
Practice Address - Fax:830-372-1531
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2081207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161800103Medicaid
TX8A3799Medicare ID - Type Unspecified
TX161800103Medicaid