Individual
GRETCHEN M VELASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
910 S BRYAN RD, SUITE 204, MISSION, TX 78572-6658
(956) 581-3900
(956) 581-3904
Mailing address
PO BOX 1748, MISSION, TX 78573-0030
(956) 581-3900
(956) 581-3904
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
L2725
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MEDICAID
—
TX
Enumeration date
12/15/2005
Last updated
07/09/2007
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