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General NPI Number Information
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NPI Number | 1184822470
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Entity Type | Organization
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Legal Business Name | MID-CITIES ARTHRITIS CLINIC, PA
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Dates
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Enumeration Date | 07/07/2007
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Last Update Date | 02/22/2008
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Provider Practice Location Address
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Address Line | 1260 HARWOOD RD
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City | BEDFORD
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State | TX
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Zip | 76021-4244
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Country | US
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Telephone | 817-358-0100
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Fax | 817-358-0125
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Provider Business Mailing Address
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Address Line | 1260 HARWOOD RD
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City | BEDFORD
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State | TX
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Zip | 76021-4244
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Country | US
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Telephone | 817-358-0100
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Fax | 817-358-0125
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Authorized Official
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Title or Position | PRESIDENT
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Name | THUAN QUANG VU
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Credential | MD
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Telephone | 817-358-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | J8412
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License Number State | TX
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