Provider Demographics
NPI:1407359722
Name:VELAZQUEZ NEGRON, IVELISSE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:IVELISSE
Middle Name:MARIE
Last Name:VELAZQUEZ NEGRON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6048 GLEN HEATHER
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4952
Mailing Address - Country:US
Mailing Address - Phone:787-362-2340
Mailing Address - Fax:830-239-0925
Practice Address - Street 1:5788 ECKHERT RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3900
Practice Address - Country:US
Practice Address - Phone:210-450-6450
Practice Address - Fax:830-239-0925
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT70722084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry