Healthcare Provider Details

I. General information

NPI: 1942507041
Provider Name (Legal Business Name): JAMES KEVIN VINALL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2011
Last Update Date: 02/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1795 N FRY RD STE 125
KATY TX
77449-3347
US

IV. Provider business mailing address

1795 N FRY RD STE 125
KATY TX
77449-3347
US

V. Phone/Fax

Practice location:
  • Phone: 210-378-6331
  • Fax:
Mailing address:
  • Phone: 210-378-6331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. JAMES KEVIN VINALL
Title or Position: OWNER
Credential: D.C.
Phone: 210-378-6331