Provider Demographics
NPI:1215113766
Name:RENE VELA D.D.S. INC.
Entity type:Organization
Organization Name:RENE VELA D.D.S. INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:361-884-2266
Mailing Address - Street 1:2201 CLEO ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78405-1914
Mailing Address - Country:US
Mailing Address - Phone:361-884-2266
Mailing Address - Fax:361-884-6448
Practice Address - Street 1:2201 CLEO ST
Practice Address - Street 2:SUITE B
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1914
Practice Address - Country:US
Practice Address - Phone:361-884-2266
Practice Address - Fax:361-884-6448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX141381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty