Provider Demographics
NPI:1861604498
Name:VELASQUEZ, PERCY (MD, LSA)
Entity type:Individual
Prefix:DR
First Name:PERCY
Middle Name:
Last Name:VELASQUEZ
Suffix:
Gender:M
Credentials:MD, LSA
Other - Prefix:
Other - First Name:PERCY
Other - Middle Name:
Other - Last Name:VELASQUEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, LSA
Mailing Address - Street 1:118 SHADOW WOOD DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-2665
Mailing Address - Country:US
Mailing Address - Phone:281-494-1315
Mailing Address - Fax:281-494-1315
Practice Address - Street 1:118 SHADOW WOOD DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-2665
Practice Address - Country:US
Practice Address - Phone:713-824-7022
Practice Address - Fax:281-494-1315
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical