Healthcare Provider Details
I. General information
NPI: 1588538433
Provider Name (Legal Business Name): FARYN KAYE VELA DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
105 SPRING GREEN BLVD # 200
VICTORIA TX
77904-7100
US
IV. Provider business mailing address
105 SPRING GREEN BLVD # 200
VICTORIA TX
77904-7100
US
V. Phone/Fax
- Phone: 361-579-2912
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QD0000X |
| Taxonomy | Dental Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
FARYN
KAYE
VELA
Title or Position: DENTIST
Credential: DDS
Phone: 361-649-6699