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NPI Code Detail

MEDICARE: VANGUARD GERIATRICS INC

MEDICARE: VANGUARD GERIATRICS INC
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
1363LG0600XGerontology Nurse Practitioner607064TX

Other Identifiers

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

General Provider Information

NPI Number : 1427325869
Entity Type Code : Organization
Provider Name (Legal Business Name) : VANGUARD GERIATRICS INC
Provider Business Mailing Address
First Line : 4660 BEECHNUT ST STE 218-SATX
Second Line :
City : HOUSTON
State : TX
Zip : 77096-1825
Country : US
Telephone Number : 713-521-0006
Fax Number :
Provider Business Practice Location Address
First Line : 4660 BEECHNUT ST STE 218
Second Line :
City : HOUSTON
State : TX
Zip : 77096-1825
Country : US
Telephone Number : 713-521-0006
Fax Number :
Authorized Official
Title or Position : CEO
Name : EDITH SPOSSEY SAX
Credential : RN MSN GNP-BC
Telephone Number : 713-521-0006
Provider Enumeration Date : 11/30/2011
Last Update Date : 11/30/2011

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Directions to “VANGUARD GERIATRICS INC ” Practice Location

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