Vitalcare Medical | |
1816 Broadway St Ste 110 Pearland TX 77581-5664 | |
(281) 482-9994 | |
(281) 482-2231 |
Full Name | Vitalcare Medical |
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Speciality | Internal Medicine |
Location | 1816 Broadway St, Pearland, Texas |
Authorized Official Name and Position | Thang Hoang (PRESIDENT) |
Authorized Official Contact | 2814829994 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Vitalcare Medical 1816 Broadway St Ste 110 Pearland TX 77581-5664 Ph: (281) 482-9994 | Vitalcare Medical 1816 Broadway St Ste 110 Pearland TX 77581-5664 Ph: (281) 482-9994 |
NPI Number | 1073675468 |
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Provider Enumeration Date | 12/14/2006 |
Last Update Date | 01/20/2022 |
Medicare PECOS PAC ID | 5799763751 |
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Medicare Enrollment ID | O20040708000213 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073675468 | NPI | - | NPPES |
167045701 | Medicaid | TX | |
167045702 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | K7167 (Texas) | Primary |
208000000X | Pediatrics | K7167 (Texas) | Secondary |
208D00000X | General Practice | K7167 (Texas) | Secondary |
Provider Name | Thang Dinh Hoang |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1932101268 PECOS PAC ID: 8325026305 Enrollment ID: I20040708000273 |
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