Individual
CARLOS ANTONIO VELAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
4201 MEDICAL DR, SAN ANTONIO, TX 78229-5656
(210) 614-4990
Mailing address
217 FAZIO DR, CIBOLO, TX 78108-3321
(808) 783-6576
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
78526
TX
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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