Provider Demographics
NPI:1255924155
Name:VESELY, ESTHER SAUGAR VELASCO
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:SAUGAR VELASCO
Last Name:VESELY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 GREATWOOD GLEN DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-6256
Mailing Address - Country:US
Mailing Address - Phone:561-301-0668
Mailing Address - Fax:
Practice Address - Street 1:2112 REGIONAL MEDICAL DR STE 1319
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-1413
Practice Address - Country:US
Practice Address - Phone:713-486-7630
Practice Address - Fax:713-500-0858
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF06202341363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner