| Vanguard Spine & Sport, Pllc | |
|
8800 Katy Fwy Ste 201 Houston TX 77024-1645 | |
| (832) 831-8656 | |
| (832) 831-8674 |
| Full Name | Vanguard Spine & Sport, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 8800 Katy Fwy Ste 201, Houston, Texas |
| Authorized Official Name and Position | Lance Iguess (OWNER) |
| Authorized Official Contact | 8328318656 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vanguard Spine & Sport, Pllc 8800 Katy Fwy Ste 201 Houston TX 77024-1645 Ph: () - | Vanguard Spine & Sport, Pllc 8800 Katy Fwy Ste 201 Houston TX 77024-1645 Ph: (832) 831-8656 |
| NPI Number | 1407360100 |
|---|---|
| Provider Enumeration Date | 11/17/2017 |
| Last Update Date | 05/03/2024 |
| Medicare PECOS PAC ID | 3971862921 |
|---|---|
| Medicare Enrollment ID | O20180119000450 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407360100 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Yvonne C Hernandez |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1043567449 PECOS PAC ID: 4486809746 Enrollment ID: I20130313000085 |
| Provider Name | Bharat Mittal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144343096 PECOS PAC ID: 6709957392 Enrollment ID: I20130909000646 |
| Provider Name | Lance Iguess |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1821362971 PECOS PAC ID: 1355664541 Enrollment ID: I20141218002250 |
| Provider Name | Kanon Oswald |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1679846265 PECOS PAC ID: 9537482724 Enrollment ID: I20141218002505 |
| Provider Name | Kiran N Virani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831690239 PECOS PAC ID: 9436413713 Enrollment ID: I20180515000391 |
| Provider Name | Andre' Joseph Mergey |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1477247849 PECOS PAC ID: 9436505906 Enrollment ID: I20231020000384 |
| Provider Name | Steve Michael Wascom |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1114642824 PECOS PAC ID: 9537521216 Enrollment ID: I20231228003638 |
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