MEDICARE: DR. QUANG ANH VU M.D.

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	207R00000X	Internal Medicine Physician	K3655	TX
2	207R00000X	Internal Medicine Physician	11854	NV

General Provider Information

NPI Number	:	1407956014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. QUANG ANH VU M.D.

Provider Business Mailing Address
First Line	:	7171 BUFFALO SPEEDWAY
Second Line	:	#1933
City	:	HOUSTON
State	:	TX
Zip	:	77025-1424
Country	:	US
Telephone Number	:	832-452-7712
Fax Number	:	832-778-9031

Provider Business Practice Location Address
First Line	:	7171 BUFFALO SPEEDWAY
Second Line	:	#1933
City	:	HOUSTON
State	:	TX
Zip	:	77025-1424
Country	:	US
Telephone Number	:	832-452-7712
Fax Number	:	832-778-9031

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

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	07/08/2007

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