Healthcare Provider Details

I. General information

NPI: 1477199321
Provider Name (Legal Business Name): VEEONE MEDICAL GROUP TEXAS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 08/27/2023
Certification Date: 08/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 ROCKY RIDGE DR STE 300
ROSEVILLE CA
95661-2835
US

IV. Provider business mailing address

1420 E ROSEVILLE PKWY STE 140-519
ROSEVILLE CA
95661-3078
US

V. Phone/Fax

Practice location:
  • Phone: 916-865-4668
  • Fax:
Mailing address:
  • Phone: 916-865-4668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: KEITH WASHINGTON
Title or Position: RCM MANAGER
Credential:
Phone: 850-459-6238