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General NPI Number Information
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NPI Number | 1629632260
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Entity Type | Organization
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Legal Business Name | VEIN CLINICS OF TEXAS
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Dates
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Enumeration Date | 04/29/2019
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 2024 RICHMOND AVE STE 300
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City | HOUSTON
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State | TX
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Zip | 77098-3424
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Country | US
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Telephone | 832-963-0766
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Fax |
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Provider Business Mailing Address
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Address Line | 244 MADISON AVE STE 1120
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City | NEW YORK
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State | NY
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Zip | 10016-2817
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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 | PRESIDENT
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Name | DR. CALVIN G JUNG
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Credential | MD
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Telephone | 646-436-3983
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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 |
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License Number State |
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