Individual
JOSE CARLOS VELASCO DI DOMENICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2000 PINE ST, ABILENE, TX 79601-2434
(325) 670-6340
(833) 437-1272
Mailing address
2000 PINE ST, ABILENE, TX 79601-2434
(325) 670-6340
(833) 437-1272
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-37190
KS
207RH0000X
Hematology (Internal Medicine) Physician
04-37190
KS
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
04-37190
KS
207RH0003X
Hematology & Oncology Physician
Primary
T7760
TX
207RX0202X
Medical Oncology Physician
04-37190
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16701016
MEDICARE
KS
05
—
200587760A
—
OK
05
—
201099520A
—
KS
05
—
201099520B
—
KS
01
—
KA3434005
MEDICARE
KS
Enumeration date
10/09/2007
Last updated
12/20/2022
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