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General NPI Number Information
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NPI Number | 1225562887
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Entity Type | Organization
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Legal Business Name | VASU MEDICAL PLLC
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Dates
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Enumeration Date | 04/19/2017
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Last Update Date | 05/02/2017
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Provider Practice Location Address
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Address Line | 450 W MEDICAL CENTER BLVD SUITE 203
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City | WEBSTER
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State | TX
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Zip | 77598-4234
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Country | US
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Telephone | 832-906-2500
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Fax | 832-906-2501
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Provider Business Mailing Address
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Address Line | 450 W MEDICAL CENTER BLVD SUITE 203
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City | WEBSTER
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State | TX
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Zip | 77598-4234
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Country | US
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Telephone | 832-906-2500
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Fax | 832-906-2501
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANAN S SHUKLA
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Credential | MD
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Telephone | 612-306-1509
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | N9300
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License Number State | TX
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