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NPI Code Detail

MEDICARE: VASCULAR CARE OF TEXAS, PLLC

MEDICARE: VASCULAR CARE OF TEXAS, PLLC
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
12086S0129XVascular Surgery Physician

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 : 1982095329
Entity Type Code : Organization
Provider Name (Legal Business Name) : VASCULAR CARE OF TEXAS, PLLC
Provider Business Mailing Address
First Line : 601 CLARA BARTON BLVD STE 350
Second Line :
City : GARLAND
State : TX
Zip : 75042-5747
Country : US
Telephone Number : 972-426-9900
Fax Number : 972-426-9899
Provider Business Practice Location Address
First Line : 601 CLARA BARTON BLVD STE 350
Second Line :
City : GARLAND
State : TX
Zip : 75042-5747
Country : US
Telephone Number : 972-426-9900
Fax Number : 972-426-9899
Authorized Official
Title or Position : PRESIDENT
Name : EDIC STEPHANIAN
Credential : MD
Telephone Number : 972-426-9900
Provider Enumeration Date : 02/06/2015
Last Update Date : 07/01/2021

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Directions to “VASCULAR CARE OF TEXAS, PLLC ” Practice Location

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