MEDICARE: QAVU, LLC

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	207L00000X	Anesthesiology Physician	J6792	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	DQ6815	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0052TJ	OTHER	TX	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619908415
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QAVU, LLC

Provider Business Mailing Address
First Line	:	PO BOX 3945
Second Line	:	DEPT 235
City	:	HOUSTON
State	:	TX
Zip	:	77253-3945
Country	:	US
Telephone Number	:	281-358-8114
Fax Number	:	281-358-0609

Provider Business Practice Location Address
First Line	:	10918 EAST FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77029-1912
Country	:	US
Telephone Number	:	713-451-4299
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. QUAN ANH VU
Credential	:	M.D.
Telephone Number	:	281-250-6298

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	03/12/2014

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Directions to “QAVU, LLC ” Practice Location

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