Theresa Silva Velasquez, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

K0391 Issued in TX

Practice address

111 S Laurel Ave
Luling, TX 78648-2624

Phone

(830) 875-6399

Fax

(830) 875-6398

NPI assigned

Dec 19, 2005

Last updated

Nov 28, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: theresa.velasquez@398008301912068.direct.elationemr.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1275519456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1890",
            "city": "GONZALES",
            "state": "TX",
            "postal_code": "786291390",
            "telephone_number": "830-672-6511",
            "fax_number": "830-672-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S LAUREL AVE",
            "city": "LULING",
            "state": "TX",
            "postal_code": "786482624",
            "telephone_number": "830-875-6399",
            "fax_number": "830-875-6398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASQUEZ",
        "first_name": "THERESA",
        "middle_name": "SILVA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K0391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120675706",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tri-County Clinical
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• Martin E Weiner, MD
• Rochelle Nicole Wilk, D.D.S.
• Audrey Yager, LAT
• Tabbatha Zamora, NP

• Pediatrics Physician in Luling, TX
• Providers in Luling, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.