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General NPI Number Information
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NPI Number | 1619248119
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Entity Type | Individual
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Provider Name | JOSE ALBERTO VELASQUEZ
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Gender | Male
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Dates
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Enumeration Date | 01/16/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 6517 FALLBROOK DR
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City | GARLAND
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State | TX
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Zip | 75043-5924
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Country | US
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Telephone | 972-400-8415
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Fax | 972-468-9839
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Provider Business Mailing Address
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Address Line | 6517 FALLBROOK DR
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City | GARLAND
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State | TX
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Zip | 75043-5924
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Country | US
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Telephone | 972-400-8415
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Fax | 972-468-9839
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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