Healthcare Provider Details

I. General information

NPI: 1760153126
Provider Name (Legal Business Name): THAO T VINING NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2021
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 MATLOCK RD STE 160
ARLINGTON TX
76002-4806
US

IV. Provider business mailing address

8200 MATLOCK RD STE 160
ARLINGTON TX
76002-4806
US

V. Phone/Fax

Practice location:
  • Phone: 817-678-6449
  • Fax:
Mailing address:
  • Phone: 817-678-6449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP1057176
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: