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General NPI Number Information
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NPI Number | 1912784133
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Entity Type | Individual
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Provider Name | SARAH JO VELA PTA
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Gender | Female
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 219 N KING ST
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City | ALICE
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State | TX
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Zip | 78332-4841
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Country | US
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Telephone | 361-664-4366
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Fax |
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Provider Business Mailing Address
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Address Line | 309 E GLORIA AVE
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City | SAN DIEGO
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State | TX
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Zip | 78384-3813
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Country | US
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Telephone | 361-227-9991
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2050987
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License Number State | TX
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