Healthcare Provider Details

I. General information

NPI: 1902821077
Provider Name (Legal Business Name): MICHAEL J. VENNIX M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7401 MAIN ST
HOUSTON TX
77030
US

IV. Provider business mailing address

1709 DRYDEN RD SUITE #725
HOUSTON TX
77030-2400
US

V. Phone/Fax

Practice location:
  • Phone: 713-799-2300
  • Fax: 281-501-5973
Mailing address:
  • Phone: 713-798-4495
  • Fax: 713-798-7259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberH6676
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: