Provider Demographics
NPI:1891174686
Name:VELIZ, CESAR ESTUARDO (PA-C)
Entity type:Individual
Prefix:
First Name:CESAR
Middle Name:ESTUARDO
Last Name:VELIZ
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16110 VIA SHAVANO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-2380
Mailing Address - Country:US
Mailing Address - Phone:210-615-7171
Mailing Address - Fax:210-615-6793
Practice Address - Street 1:16110 VIA SHAVANO
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2380
Practice Address - Country:US
Practice Address - Phone:210-615-7171
Practice Address - Fax:210-615-6793
Is Sole Proprietor?:No
Enumeration Date:2015-05-26
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1125523363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant