Healthcare Provider Details

I. General information

NPI: 1447696240
Provider Name (Legal Business Name): VIETWELL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 W PIONEER PKWY STE 130
ARLINGTON TX
76010-6146
US

IV. Provider business mailing address

124 W PIONEER PKWY STE 130
ARLINGTON TX
76010-6146
US

V. Phone/Fax

Practice location:
  • Phone: 817-726-4242
  • Fax: 817-288-0899
Mailing address:
  • Phone: 817-299-8888
  • Fax: 817-288-0899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number015797
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number015797
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number015797
License Number StateTX

VIII. Authorized Official

Name: MR. TOMMY VAN KHONG
Title or Position: PRESIDENT
Credential:
Phone: 817-937-7675