Provider Demographics
NPI:1013955319
Name:VELASCO, CARLOS E (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:E
Last Name:VELASCO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8440 WALNUT HILL LN
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-3833
Mailing Address - Country:US
Mailing Address - Phone:214-361-3300
Mailing Address - Fax:214-361-3431
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:SUITE 851
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1800
Practice Address - Country:US
Practice Address - Phone:214-826-6044
Practice Address - Fax:214-823-7183
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2007-12-01
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Provider Licenses
StateLicense IDTaxonomies
TXJ3254207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G03370Medicare UPIN
879263Medicare PIN