Healthcare Provider Details

I. General information

NPI: 1992998090
Provider Name (Legal Business Name): JUAN JOSE VUELVAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9615 FRANKFORD AVE FL 1
LUBBOCK TX
79424-4461
US

IV. Provider business mailing address

5219 CITY BANK PKWY STE 35
LUBBOCK TX
79407
US

V. Phone/Fax

Practice location:
  • Phone: 806-761-0265
  • Fax: 806-761-0266
Mailing address:
  • Phone: 806-761-0333
  • Fax: 806-782-0097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberN6759
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: