MEDICARE: DR. VICTOR D VELA MD

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
1	207Q00000X	Family Medicine Physician	G7904	TX

General Provider Information

NPI Number	:	1669467031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VICTOR D VELA MD

Provider Business Mailing Address
First Line	:	136 OLD SAN ANTONIO RD STE 406
Second Line	:
City	:	BOERNE
State	:	TX
Zip	:	78006-3341
Country	:	US
Telephone Number	:	830-331-4270
Fax Number	:	830-331-4218

Provider Business Practice Location Address
First Line	:	136 OLD SAN ANTONIO RD STE 406
Second Line	:
City	:	BOERNE
State	:	TX
Zip	:	78006-3341
Country	:	US
Telephone Number	:	830-331-4270
Fax Number	:	830-331-4218

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	12/04/2020

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