MEDICARE: DANNY VINING PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1043662	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R855135	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306175138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANNY VINING PMHNP

Provider Business Mailing Address
First Line	:	6514 HIGHWAY 90A STE 101
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77498-2120
Country	:	US
Telephone Number	:	281-915-2370
Fax Number	:	281-791-2374

Provider Business Practice Location Address
First Line	:	540 MADISON OAK DR STE 340
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-3921
Country	:	US
Telephone Number	:	281-915-2370
Fax Number	:	888-894-2635

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

Provider Enumeration Date	:	12/07/2009
Last Update Date	:	06/24/2026

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