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General NPI Number Information
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NPI Number | 1174929145
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Entity Type | Organization
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Legal Business Name | LIXANA VEGA VEGA MD PLLC
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Dates
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Enumeration Date | 11/18/2014
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Last Update Date | 11/27/2019
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Provider Practice Location Address
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Address Line | 950 THREADNEEDLE STREET SUITE 140
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City | HOUSTON
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State | TX
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Zip | 77079
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Country | US
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Telephone | 832-699-8342
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Fax | 888-974-1574
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Provider Business Mailing Address
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Address Line | 603 WHITE JASMINE TRL
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City | HOUSTON
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State | TX
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Zip | 77079-1124
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LIXANA VEGA
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Credential | MD
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Telephone | 832-647-9311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | P0511
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License Number State | TX
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