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NPI Code Detail

MEDICARE: DR. POVILAS VITENAS JR. M.D.

MEDICARE: DR. POVILAS VITENAS JR. 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
1174400000XSpecialistH8882TX

General Provider Information

NPI Number : 1972549459
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. POVILAS VITENAS JR. M.D.
Provider Business Mailing Address
First Line : 4208 RICHMOND AVE
Second Line : SUITE 200
City : HOUSTON
State : TX
Zip : 77027-6839
Country : US
Telephone Number : 281-484-0088
Fax Number : 281-484-7717
Provider Business Practice Location Address
First Line : 4208 RICHMOND AVE
Second Line : SUITE 200
City : HOUSTON
State : TX
Zip : 77027-6839
Country : US
Telephone Number : 281-484-0088
Fax Number : 281-484-7717
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2006
Last Update Date : 08/12/2014

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