Provider Demographics
NPI:1285673152
Name:TILNEY, VANESSA (MD)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:TILNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 CHENEVERT ST
Mailing Address - Street 2:UNIT B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-3012
Mailing Address - Country:US
Mailing Address - Phone:713-524-0405
Mailing Address - Fax:
Practice Address - Street 1:4545 POST OAK PLACE DR
Practice Address - Street 2:SUITE 130
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3164
Practice Address - Country:US
Practice Address - Phone:713-960-8008
Practice Address - Fax:713-960-0965
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7223207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8A9441Medicare PIN
H90970Medicare UPIN