Individual
MARIO VELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP, DNP
Contact information
Practice address
5055 MCNUTT RD, SANTA TERESA, NM 88008-9442
(575) 589-5005
(575) 589-1333
Mailing address
5055 MCNUTT RD, SANTA TERESA, NM 88008-9442
(575) 589-5005
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP114354
TX
363LF0000X
Family Nurse Practitioner
Primary
CNP017111
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3394272-01
—
TX
01
—
8090NJ
BCBS
TX
Enumeration date
05/11/2006
Last updated
07/21/2022
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