Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | L9948 | TX |
NPI | 1053328336 |
---|---|
Provider Name | Luis E Velez |
First Address | Saint Louis, MO 63150-4152 |
Second Address | San Antonio, TX 78207-8101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 26/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
166083905 | (05) | TX |