MEDICARE: MR. DAVID VELA JR. R.PH.

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	183500000X	Pharmacist	28232	TX

General Provider Information

NPI Number	:	1902191885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID VELA JR. R.PH.

Provider Business Mailing Address
First Line	:	18255 BLANCO RD
Second Line	:	T-1354
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4585
Country	:	US
Telephone Number	:	210-764-7972
Fax Number	:	210-764-7972

Provider Business Practice Location Address
First Line	:	18255 BLANCO RD
Second Line	:	T-1354
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4585
Country	:	US
Telephone Number	:	210-764-7972
Fax Number	:	210-764-7972

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

Provider Enumeration Date	:	06/18/2011
Last Update Date	:	06/18/2011

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