Provider Demographics
NPI:1386300408
Name:SAUCEDA, VERONICA C (DO)
Entity type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:C
Last Name:SAUCEDA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4470 MOUNTAIN PASS
Mailing Address - Street 2:
Mailing Address - City:VON ORMY
Mailing Address - State:TX
Mailing Address - Zip Code:78073-5136
Mailing Address - Country:US
Mailing Address - Phone:210-209-5570
Mailing Address - Fax:
Practice Address - Street 1:5807 S ZARZAMORA ST STE 102
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-2020
Practice Address - Country:US
Practice Address - Phone:210-209-5570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-12
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314496164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse