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General NPI Number Information
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NPI Number | 1477763191
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Entity Type | Organization
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Legal Business Name | VANGUARD UROLOGIC ASSOCIATES, PLLC
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 6400 FANNIN ST STE 2300
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City | HOUSTON
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State | TX
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Zip | 77030-1511
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Country | US
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Telephone | 713-366-7848
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Fax | 713-366-7999
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Provider Business Mailing Address
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Address Line | 6400 FANNIN ST SUITE 2300
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City | HOUSTON
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State | TX
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Zip | 77030-1521
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Country | US
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Telephone | 713-366-7848
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Fax | 713-366-7999
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. KEVIN M SLAWIN
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Credential | MD
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Telephone | 713-366-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | J3225
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License Number State | TX
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