Provider Demographics
NPI:1235573155
Name:VASQUEZ, NIEVES
Entity Type:Individual
Prefix:MR
First Name:NIEVES
Middle Name:
Last Name:VASQUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9238 FRIENDSHIP RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-2915
Mailing Address - Country:US
Mailing Address - Phone:713-460-4289
Mailing Address - Fax:713-460-4289
Practice Address - Street 1:9238 FRIENDSHIP RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-2915
Practice Address - Country:US
Practice Address - Phone:713-460-4289
Practice Address - Fax:713-460-4289
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32050622714343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)