Healthcare Provider Details

I. General information

NPI: 1841860228
Provider Name (Legal Business Name): KEVIN VU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2021
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3080 COLLEGE ST
BEAUMONT TX
77701-4606
US

IV. Provider business mailing address

3080 COLLEGE ST
BEAUMONT TX
77701-4606
US

V. Phone/Fax

Practice location:
  • Phone: 409-212-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberW7633
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: