MEDICARE: VANTAGE SPECIALTY HEALTH SERVICES, LLC

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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1306211990
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANTAGE SPECIALTY HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	2306 RAYFORD RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1707
Country	:	US
Telephone Number	:	281-453-7777
Fax Number	:

Provider Business Practice Location Address
First Line	:	2306 RAYFORD RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1707
Country	:	US
Telephone Number	:	832-482-9595
Fax Number	:	832-482-9596

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	HUONG LE
Credential	:	MD
Telephone Number	:	281-453-7777

Provider Enumeration Date	:	12/08/2015
Last Update Date	:	10/22/2024

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