Basic Information
| Provider Information | |||||||||
| NPI: | 1992998090 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VUELVAS | ||||||||
| FirstName: | JUAN | ||||||||
| MiddleName: | JOSE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5219 CITY BANK PKWY STE 35 | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067610333 | ||||||||
| FaxNumber: | 8067820097 | ||||||||
| Practice Location | |||||||||
| Address1: | 502 EAST HIGHWAY 62/82 | ||||||||
| Address2: | |||||||||
| City: | WOLFFORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8068660158 | ||||||||
| FaxNumber: | 8068660162 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2007 | ||||||||
| LastUpdateDate: | 03/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | N6759 | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.