Healthcare Provider Details

I. General information

NPI: 1346862497
Provider Name (Legal Business Name): ANKIT VYAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2020
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N KOBAYASHI STE A
WEBSTER TX
77598-4722
US

IV. Provider business mailing address

12121 RICHMOND AVE STE 104
HOUSTON TX
77082-2420
US

V. Phone/Fax

Practice location:
  • Phone: 281-724-7341
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number336100
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberW2017
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number336100
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: