Organization Active NPI

Roger a Velasquez MD MPH PLLC

  • Glaucoma Specialist (Ophthalmology) Physician
  • San Antonio, TX
National Provider Identifier
1851883011
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Glaucoma Specialist (Ophthalmology) PhysicianTaxonomy code 207WX0009X
License
P9481 Issued in TX
Legal business name
ROGER A VELASQUEZ MD MPH PLLC
Practice address
6810 West Ave
San Antonio, TX 78213-1817
Phone
(210) 415-6931
NPI assigned
Jun 4, 2018
Last updated
Dec 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Authorized official

Name
Mrs. Stephanie Velasquez
Title
Administrator
Phone
(210) 983-3937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Glaucoma Specialist (Ophthalmology) Physician 207WX0009X P9481 TX Primary

Addresses

Primary practice location

6810 West Ave
San Antonio, TX 78213-1817

Mailing address

110 Larkwood Dr
San Antonio, TX 78209-2908
Phone (210) 415-6931

Other identifiers 1

IdentifierTypeStateIssuer
336193303MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180717000273 TX Part B Supplier - Clinic/Group Practice 0143577536 Receives reassigned benefits from 1 practitioner
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Locations

6810 West Ave
San Antonio, TX 78213
Phone (210) 415-6931

6810 West Ave
Ste A
San Antonio, TX 78213
Phone (210) 496-9992

6810 West Ave
Unit A
San Antonio, TX 78213
Phone (210) 415-6931

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734393600000",
    "number": "1851883011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LARKWOOD DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782092908",
            "telephone_number": "210-415-6931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6810 WEST AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131817",
            "telephone_number": "210-415-6931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER A VELASQUEZ MD MPH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-04",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-13",
        "status": "A",
        "authorized_official_last_name": "VELASQUEZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "210-983-3937",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207WX0009X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": "TX",
            "license": "P9481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336193303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.