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General NPI Number Information
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NPI Number | 1548252430
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Entity Type | Individual
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Provider Name | THANH J VAN MD
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Gender | Male
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 4223 RICHMOND AVE
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City | HOUSTON
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State | TX
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Zip | 77027-6813
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Country | US
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Telephone | 713-351-0644
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Fax | 713-351-0633
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Provider Business Mailing Address
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Address Line | PO BOX 1400
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City | HOUSTON
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State | TX
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Zip | 77251-1400
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Country | US
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Telephone | 713-351-0644
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Fax | 713-351-0633
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | L1488
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License Number State | TX
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