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General NPI Number Information
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NPI Number | 1922556000
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Entity Type | Individual
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Provider Name | JEN M VELDHUYZEN MD
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Gender | Female
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 07/30/2024
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Provider Practice Location Address
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Address Line | 539 W COMMERCE ST # 213
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City | DALLAS
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State | TX
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Zip | 75208-1953
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Country | US
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Telephone | 254-255-8404
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Fax |
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Provider Business Mailing Address
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Address Line | 2003 PLANK RD # 1089
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-5103
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Country | US
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Telephone | 254-255-8404
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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 | 171000000X
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Taxonomy Name | Military Health Care Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0101265916
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License Number State | VA
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