Healthcare Provider Details

I. General information

NPI: 1669121455
Provider Name (Legal Business Name): CHRISTEL VELASCO-GUIDRY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTEL VELASCO MD

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9409 OLD BURKE LAKE RD STE B
BURKE VA
22015-3127
US

IV. Provider business mailing address

9409 OLD BURKE LAKE RD STE B
BURKE VA
22015-3127
US

V. Phone/Fax

Practice location:
  • Phone: 703-978-4200
  • Fax:
Mailing address:
  • Phone: 703-978-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101286228
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: