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General NPI Number Information
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NPI Number | 1760849897
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Entity Type | Organization
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Legal Business Name | VISION PARK DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 01/20/2016
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Last Update Date | 01/20/2016
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Provider Practice Location Address
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Address Line | 114 VISION PARK BLVD STE 100
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City | SHENANDOAH
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State | TX
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Zip | 77384-3008
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Country | US
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Telephone | 936-321-1700
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Fax | 936-273-8900
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Provider Business Mailing Address
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Address Line | PO BOX 3525
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City | VICTORIA
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State | TX
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Zip | 77903-3525
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Country | US
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Telephone | 361-485-9400
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Fax | 361-485-9933
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL HOANG
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Credential | D.O.
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Telephone | 361-652-0025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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