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General NPI Number Information
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NPI Number | 1568610038
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Entity Type | Organization
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Legal Business Name | VANESSA L VELA MARTINEZ M.D.
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 09/08/2008
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Provider Practice Location Address
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Address Line | 525 OAK CENTRE DR STE 170
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3944
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Country | US
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Telephone | 210-495-4888
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Fax | 210-495-1333
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Provider Business Mailing Address
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Address Line | 2218 SAWGRASS RDG
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City | SAN ANTONIO
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State | TX
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Zip | 78260-7237
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Country | US
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Telephone | 210-685-9900
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Fax | 210-495-1333
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | VANESSA L VELA MARTINEZ
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Credential | M.D.
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Telephone | 210-495-4888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | L5999
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License Number State | TX
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