Provider Demographics
NPI:1295714871
Name:VELING, MARIA CLEMENCIA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:CLEMENCIA
Last Name:VELING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:CLEMENCIA
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-456-2905
Mailing Address - Fax:214-456-6086
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7201
Practice Address - Country:US
Practice Address - Phone:214-456-2905
Practice Address - Fax:214-456-6086
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1527207Y00000X, 207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000381956OtherANTHEM - NICC
IN200182210Medicaid
KY64305352Medicaid
KYP00337940OtherRAILROAD MEDICARE - NICC
IN196290WWMedicare UPIN
KY64305352Medicaid
KY0998809Medicare PIN