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General NPI Number Information
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NPI Number | 1770107856
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Entity Type | Organization
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Legal Business Name | VASCULAR INSTITUTE OF HOUSTON PLLC
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 7515 MAIN ST STE 100
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City | HOUSTON
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State | TX
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Zip | 77030-4549
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Country | US
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Telephone | 832-777-7570
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Fax | 281-709-2575
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Provider Business Mailing Address
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Address Line | 635 ANDERSON RD STE 4
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City | DAVIS
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State | CA
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Zip | 95616-3505
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Country | US
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Telephone | 832-777-7570
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Fax | 281-709-2575
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | BONNIE POTTER
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Credential |
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Telephone | 916-846-9454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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