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General NPI Number Information
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NPI Number | 1205009099
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Entity Type | Individual
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Provider Name | CARLOS ANDRES ESTRADA VELEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2008
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVENUE
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City | DANVILLE
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State | PA
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Zip | 17822-0001
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Country | US
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Telephone | 570-271-6211
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Fax |
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Provider Business Mailing Address
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Address Line | 25642 LAKOTA WINTER
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City | SAN ANTONIO
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State | TX
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Zip | 78261-2885
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Country | US
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Telephone | 570-380-3155
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | P9559
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101253144
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License Number State | VA
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