MEDICARE: KIM ANH VU PA-C

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	363AM0700X	Medical Physician Assistant	PA08991	TX
2	363A00000X	Physician Assistant	PA08991	TX

General Provider Information

NPI Number	:	1033524327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM ANH VU PA-C

Provider Business Mailing Address
First Line	:	PO BOX 392929
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15251-9900
Country	:	US
Telephone Number	:	713-461-2915
Fax Number	:	713-461-5307

Provider Business Practice Location Address
First Line	:	2103 FM 2920 RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-3412
Country	:	US
Telephone Number	:	713-461-2915
Fax Number	:	713-461-5307

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2014
Last Update Date	:	07/15/2024

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Directions to “ KIM ANH VU PA-C” Practice Location

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