MEDICARE: DR. LOUISE G VANASSE M.D.

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	2080P0205X	Pediatric Endocrinology Physician	J3693	TX

General Provider Information

NPI Number	:	1669685822
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUISE G VANASSE M.D.

Provider Business Mailing Address
First Line	:	6237 TERWILLIGER WAY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-2803
Country	:	US
Telephone Number	:	832-419-8201
Fax Number	:

Provider Business Practice Location Address
First Line	:	9539 HUFFMEISTER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-2856
Country	:	US
Telephone Number	:	281-855-9991
Fax Number	:	281-855-9992

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	05/20/2019

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