Organization Name: | VANTAGE SPECIALTY HEALTH SERVICES, LLC |
NPI Number: | 1306211990 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MINH C NGUYEN (OWNER) |
Mailing Address: | 20320 Northwest Fwy Suite 900 Jersey Village |
State: | TX US |
Postal Code: | 770655641 |
Phone Number: | 2814537916 |
Fax Number: | 2814402020 |
NPI Enumeration Date: | 12/08/2015 |
NPI Last Update Date: | 12/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |