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NPI Code Detail

MEDICARE: DOROTHY VELA PTA

MEDICARE: DOROTHY VELA PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2082031TX

General Provider Information

NPI Number : 1568928166
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOROTHY VELA PTA
Provider Business Mailing Address
First Line : 1111 E 5TH ST
Second Line :
City : ALICE
State : TX
Zip : 78332-3807
Country : US
Telephone Number : 361-389-4575
Fax Number :
Provider Business Practice Location Address
First Line : 138 S FM 1329
Second Line :
City : SAN DIEGO
State : TX
Zip : 78384-3925
Country : US
Telephone Number : 361-279-8291
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2019
Last Update Date : 02/19/2019

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Directions to “ DOROTHY VELA PTA” Practice Location

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