MEDICARE: VY LAN HO PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA17337	TX

General Provider Information

NPI Number	:	1265131890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VY LAN HO PA-C

Provider Business Mailing Address
First Line	:	5627 FM 1960 RD W STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-4200
Country	:	US
Telephone Number	:	832-688-8946
Fax Number	:	832-688-8621

Provider Business Practice Location Address
First Line	:	5627 FM 1960 RD W STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77069-4200
Country	:	US
Telephone Number	:	832-688-8946
Fax Number	:	832-688-8621

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2023
Last Update Date	:	06/24/2024

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Directions to “ VY LAN HO PA-C” Practice Location

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