MEDICARE: VASCULAR ANESTHESIA ASSOCIATES PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	207RI0011X	Interventional Cardiology Physician
3	367500000X	Certified Registered Nurse Anesthetist

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346706173
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VASCULAR ANESTHESIA ASSOCIATES PLLC

Provider Business Mailing Address
First Line	:	PO BOX 66791
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77266-6791
Country	:	US
Telephone Number	:	713-993-6053
Fax Number	:	866-810-8005

Provider Business Practice Location Address
First Line	:	800 WILCREST DR STE 213
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-1360
Country	:	US
Telephone Number	:	713-993-6053
Fax Number	:	866-810-8005

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	DAVID PROFIT
Credential	:	CRNA
Telephone Number	:	713-993-6053

Provider Enumeration Date	:	02/18/2019
Last Update Date	:	04/17/2026

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