Healthcare Provider Details

I. General information

NPI: 1326225400
Provider Name (Legal Business Name): CONNIE S VEAZEY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 VILLAGE VIEW DR
MAURICE LA
70555-4461
US

IV. Provider business mailing address

125 VILLAGE VIEW DR
MAURICE LA
70555-4461
US

V. Phone/Fax

Practice location:
  • Phone: 832-595-4641
  • Fax:
Mailing address:
  • Phone: 832-595-4641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1027
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number36025
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: