Healthcare Provider Details

I. General information

NPI: 1891174686
Provider Name (Legal Business Name): CESAR ESTUARDO VELIZ PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16110 VIA SHAVANO
SAN ANTONIO TX
78249-2380
US

IV. Provider business mailing address

16110 VIA SHAVANO
SAN ANTONIO TX
78249-2380
US

V. Phone/Fax

Practice location:
  • Phone: 210-615-7171
  • Fax: 210-615-6793
Mailing address:
  • Phone: 210-615-7171
  • Fax: 210-615-6793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA15971
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: