Provider Demographics
NPI:1386205136
Name:VELA, JEREMY JASON (DDS)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:JASON
Last Name:VELA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 KATY FWY STE 280
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1645
Mailing Address - Country:US
Mailing Address - Phone:713-365-9904
Mailing Address - Fax:713-365-9856
Practice Address - Street 1:8800 KATY FWY STE 280
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1645
Practice Address - Country:US
Practice Address - Phone:133-659-9047
Practice Address - Fax:713-365-9856
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-24
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX352091223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice