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General NPI Number Information
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NPI Number | 1801339742
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Entity Type | Organization
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Legal Business Name | VANGUARD INPATIENT PHYSICIAN PLLC
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Dates
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Enumeration Date | 11/27/2016
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 4645 SWEETWATER BLVD STE 200
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City | SUGAR LAND
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State | TX
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Zip | 77479-3016
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Country | US
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Telephone | 281-666-8065
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Fax | 281-666-8475
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Provider Business Mailing Address
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Address Line | 4645 SWEETWATER BLVD STE 200
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City | SUGAR LAND
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State | TX
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Zip | 77479-3016
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Country | US
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Telephone | 281-666-8065
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Fax | 281-666-8475
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Authorized Official
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Title or Position | OFFICER
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Name | ARUSHA BAVARE
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Credential |
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Telephone | 281-666-8065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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