MEDICARE: JAIME JOEL VELA OD

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	152W00000X	Optometrist	04567TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	04567TG	OTHER	TX	STATE LICENSE

General Provider Information

NPI Number	:	1972829646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIME JOEL VELA OD

Provider Business Mailing Address
First Line	:	PO BOX 51286
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76206-1286
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 E CALIFORNIA ST
Second Line	:
City	:	GAINESVILLE
State	:	TX
Zip	:	76240-4005
Country	:	US
Telephone Number	:	940-668-7500
Fax Number	:	940-665-7377

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

Provider Enumeration Date	:	04/20/2010
Last Update Date	:	02/01/2021

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