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NPI Code Detail

MEDICARE: DR. RICARDO VELA M.D.

MEDICARE: DR. RICARDO VELA M.D.
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
1207Q00000XFamily Medicine PhysicianM6931TX

General Provider Information

NPI Number : 1679763486
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICARDO VELA M.D.
Provider Business Mailing Address
First Line : 2106 N MAIN ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76164-8511
Country : US
Telephone Number : 817-625-4254
Fax Number : 817-625-8451
Provider Business Practice Location Address
First Line : 2106 N MAIN ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76164-8511
Country : US
Telephone Number : 817-625-4254
Fax Number : 817-625-8451
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2007
Last Update Date : 12/11/2014

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