Provider Demographics
NPI:1649469131
Name:VELEZ, CARLOS A (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:A
Last Name:VELEZ
Suffix:
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 1:11551 CEDAR OAK DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6028
Mailing Address - Country:US
Mailing Address - Phone:915-544-0817
Mailing Address - Fax:915-544-9983
Practice Address - Street 1:11551 CEDAR OAK DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6028
Practice Address - Country:US
Practice Address - Phone:915-544-0817
Practice Address - Fax:915-544-9983
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3491207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133207404Medicaid
NM0000X7370Medicaid
TXC22961Medicare UPIN
TX133207404Medicaid