MEDICARE: DR. FRANCOISE THOMAS VANDAELE 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	174400000X	Specialist	G2623	TX
2	207VG0400X	Gynecology Physician	G2623	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8FL055	OTHER	TX	BLUE CROSS BLUE SHIELD
2	8FX462	OTHER	TX	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457359580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANCOISE THOMAS VANDAELE M.D.

Provider Business Mailing Address
First Line	:	2060 SPACE PARK DR
Second Line	:	SUITE 410
City	:	HOUSTON
State	:	TX
Zip	:	77058-3600
Country	:	US
Telephone Number	:	281-334-6875
Fax Number	:	281-334-0664

Provider Business Practice Location Address
First Line	:	2060 SPACE PARK DR
Second Line	:	SUITE 410
City	:	HOUSTON
State	:	TX
Zip	:	77058-3600
Country	:	US
Telephone Number	:	281-334-6875
Fax Number	:	281-334-0664

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	08/30/2016

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Directions to “ DR. FRANCOISE THOMAS VANDAELE M.D.” Practice Location

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