Provider Demographics
NPI:1912079401
Name:VELA, EFRAIM JR (MD)
Entity Type:Individual
Prefix:DR
First Name:EFRAIM
Middle Name:
Last Name:VELA
Suffix:JR
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:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:563-622-4659
Mailing Address - Fax:956-362-2466
Practice Address - Street 1:2821 MICHAELANGELO DR STE 202
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-1406
Practice Address - Country:US
Practice Address - Phone:956-362-2465
Practice Address - Fax:956-362-2466
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8356207V00000X
ORMD42442207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0020LMOtherBLUE CROSS BLUE SHIELD
TX4252002OtherAETNA
TX135936101OtherVALLEY HEALTH PLAN
TX117852704Medicaid
TX117852704Medicaid
TX753104523OtherOLD TAX ID NUMBER
TX900210632OtherTAX ID NUMBER
TX117852704Medicaid