=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700248945
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIAN VELEZ MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/27/2016
-----------------------------------------------------
Last Update Date | 03/23/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1200 E SAVANNAH AVE STE 10
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78503-1728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-362-6680
-----------------------------------------------------
Fax | 956-362-6688
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 749
-----------------------------------------------------
City | PHARR
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78577-1614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-362-6680
-----------------------------------------------------
Fax | 956-362-6688
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | S6083
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------