MEDICARE: ALEJANDRO MARINOS VELARDE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	4301102654	MI
2	207R00000X	Internal Medicine Physician	35 128232	OH
3	207RH0000X	Hematology (Internal Medicine) Physician	S0939	TX
4	207RH0003X	Hematology & Oncology Physician	S0939	TX

General Provider Information

NPI Number	:	1750722260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEJANDRO MARINOS VELARDE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-7208
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6202 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-8565
Country	:	US
Telephone Number	:	214-645-3999
Fax Number	:	214-648-4152

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2013
Last Update Date	:	03/25/2024

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