Healthcare Provider Details

I. General information

NPI: 1609905728
Provider Name (Legal Business Name): THE VEIN CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6750 POPLAR AVE SUITE 210
MEMPHIS TN
38138-7438
US

IV. Provider business mailing address

6750 POPLAR AVE SUITE 210
MEMPHIS TN
38138-7438
US

V. Phone/Fax

Practice location:
  • Phone: 901-757-5740
  • Fax: 901-758-8047
Mailing address:
  • Phone: 901-757-5740
  • Fax: 901-758-8047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LOUIS BARRY OSTROW
Title or Position: CHIEF MANAGER
Credential: M.D.
Phone: 901-757-5740