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General NPI Number Information
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NPI Number | 1932496205
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Entity Type | Individual
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Provider Name | JON VELOSO JR. PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 07/06/2011
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 9625 WHITE SETTLEMENT RD
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City | FORT WORTH
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State | TX
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Zip | 76108-4406
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Country | US
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Telephone | 817-367-3469
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 70
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City | KELLER
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State | TX
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Zip | 76244-0070
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 49953
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License Number State | TX
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