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Individual

RICARDO S VELASQUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
128 MARKET ST, ALAMOSA, CO 81101
(719) 589-5161
(719) 589-5722
Mailing address
128 MARKET ST, ALAMOSA, CO 81101-2290
(719) 589-5161
(719) 589-5722

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21102
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01211028
CO
01
080115191
TRAVELERS MEDICARE
01
29108
NEW MEXICO MEDICAID
01
840706945043
ROCKY MOUNTAIN HEALTH PLA
CO
01
P8B200998
TEXAS MEDICAID
01
VE246518
ANTHEM BCBS
CO
Enumeration date
10/17/2005
Last updated
03/30/2016
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