MEDICARE: V.N.J. TRIPLE STARS

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	332B00000X	Durable Medical Equipment & Medical Supplies	1219344	TX

General Provider Information

NPI Number	:	1962429977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	V.N.J. TRIPLE STARS

Provider Business Mailing Address
First Line	:	9898 BISSONNET ST
Second Line	:	SUITE 593
City	:	HOUSTON
State	:	TX
Zip	:	77036-8270
Country	:	US
Telephone Number	:	832-541-3819
Fax Number	:	713-484-5521

Provider Business Practice Location Address
First Line	:	9898 BISSONNET ST
Second Line	:	SUITE 593
City	:	HOUSTON
State	:	TX
Zip	:	77036-8270
Country	:	US
Telephone Number	:	832-541-3819
Fax Number	:	713-484-5521

Authorized Official
Title or Position	:	CHEIF CONSULTANT
Name	:	MR. VIC A NWANKPAH
Credential	:
Telephone Number	:	832-541-3819

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	08/22/2020

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