Provider Demographics
NPI:1801080346
Name:VELAZCO-VAZQUEZ, XIOMARA (MD)
Entity type:Individual
Prefix:
First Name:XIOMARA
Middle Name:
Last Name:VELAZCO-VAZQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:XIOMARA
Other - Middle Name:
Other - Last Name:VELAZCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4800 NE STALLINGS DR
Mailing Address - Street 2:STE. 1500
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1249
Mailing Address - Country:US
Mailing Address - Phone:936-715-9470
Mailing Address - Fax:936-715-9475
Practice Address - Street 1:4800 NE STALLINGS DR
Practice Address - Street 2:STE. 1500
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1249
Practice Address - Country:US
Practice Address - Phone:936-715-9470
Practice Address - Fax:936-715-9475
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME128038208M00000X, 207R00000X
TXN6749207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist