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General NPI Number Information
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NPI Number | 1851507883
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Entity Type | Organization
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Legal Business Name | J. MARIO VELASQUEZ D.D.S.
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 9388 RICHMOND AVE
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City | HOUSTON
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State | TX
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Zip | 77063-3947
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Country | US
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Telephone | 713-785-3355
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Fax | 713-785-7007
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Provider Business Mailing Address
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Address Line | 9388 RICHMOND AVE
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City | HOUSTON
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State | TX
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Zip | 77063-3947
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Country | US
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Telephone | 713-785-3355
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Fax | 713-785-7007
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Authorized Official
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Title or Position | MANAGER
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Name | CAROL P JARAMILLO
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Credential | OM
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Telephone | 713-785-3355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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