MEDICARE: VVCTX, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	202K00000X	Phlebology Physician

General Provider Information

NPI Number	:	1013783497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VVCTX, PLLC

Provider Business Mailing Address
First Line	:	4721 HOLLAND LN
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75010-4594
Country	:	US
Telephone Number	:	312-718-2368
Fax Number	:

Provider Business Practice Location Address
First Line	:	137 E STATE HIGHWAY 121 STE 100
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-7984
Country	:	US
Telephone Number	:	312-718-2368
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. SATISH VAYUVEGULA
Credential	:	MD
Telephone Number	:	312-718-2368

Provider Enumeration Date	:	11/28/2023
Last Update Date	:	11/28/2023

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