Individual
JENILETTE VELASCO CRISTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10091
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
353259001
—
TX
01
—
8570NT
BCBS
TX
01
—
Q00063332
RAILROAD MEDICARE
TX
Enumeration date
11/17/2015
Last updated
04/27/2021
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