Provider Demographics
NPI:1821181678
Name:VELA, RAUL III (MD)
Entity Type:Individual
Prefix:
First Name:RAUL
Middle Name:
Last Name:VELA
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 FLOYD CURL DRIVE
Mailing Address - Street 2:SUITE 909
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229
Mailing Address - Country:US
Mailing Address - Phone:210-614-3575
Mailing Address - Fax:210-692-7116
Practice Address - Street 1:7950 FLOYD CURL DRIVE
Practice Address - Street 2:SUITE 909
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-614-3575
Practice Address - Fax:210-692-7116
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8479207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097579902Medicaid
00B840Medicare ID - Type Unspecified