MEDICARE: DR. QUAN ANH VU MD

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	J6792	TX

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	050065422	OTHER	TX	MCR RAILROAD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	89688K	OTHER	TX	BLUE CROSS BLUE SHIELD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	8GK806	OTHER	TX	BCBS
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	70089916	OTHER	TX	DPS
11	8W4791	OTHER	TX	BLUE CROSS BLUE SHIELD

NPI Number	:	1578558599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QUAN ANH VU MD

Provider Business Mailing Address
First Line	:	PO BOX 840853
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-0865
Country	:	US
Telephone Number	:	972-715-5000
Fax Number	:	972-233-3666

Provider Business Practice Location Address
First Line	:	1500 CITYWEST BLVD
Second Line	:	STE. 300
City	:	HOUSTON
State	:	TX
Zip	:	77042-2300
Country	:	US
Telephone Number	:	713-620-4000
Fax Number	:	713-458-4229

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	03/07/2023

1500 CITYWEST BLVD , SUITE 300
HOUSTON, TX
77042-2300

Practice Phone: 972-715-5000
Practice Fax: 972-715-9976

1500 CITYWEST BLVD , STE. 300
HOUSTON, TX
77042-2300