Individual
DHYANA VELASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4705 MONTGOMERY BLVD NE STE 301, ALBUQUERQUE, NM 87109-1234
(505) 727-4500
(505) 727-4505
Mailing address
1013 GIRARD BLVD NE, ALBUQUERQUE, NM 87106-2014
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD2019-0767
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72122731
—
NM
Enumeration date
04/02/2015
Last updated
10/16/2019
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