Provider Demographics
NPI:1962605626
Name:VELANDIA, LUZ (DMD)
Entity type:Individual
Prefix:
First Name:LUZ
Middle Name:
Last Name:VELANDIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6419 BISSONNET ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-6502
Mailing Address - Country:US
Mailing Address - Phone:713-772-1558
Mailing Address - Fax:
Practice Address - Street 1:6419 BISSONNET ST
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-6502
Practice Address - Country:US
Practice Address - Phone:713-772-1558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10835122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist