Provider Demographics
NPI:1699107037
Name:VELA, SELINA R (PHARMD)
Entity type:Individual
Prefix:
First Name:SELINA
Middle Name:R
Last Name:VELA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 SABINE ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7443
Mailing Address - Country:US
Mailing Address - Phone:956-222-6926
Mailing Address - Fax:
Practice Address - Street 1:3600 W NOLANA AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4594
Practice Address - Country:US
Practice Address - Phone:956-618-7701
Practice Address - Fax:956-618-7711
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40503183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist