Provider Demographics
NPI:1346706173
Name:VASCULAR ANESTHESIA ASSOCIATES PLLC
Entity Type:Organization
Organization Name:VASCULAR ANESTHESIA ASSOCIATES PLLC
Other - Org Name:VASCULAR ANESTHESIA ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PROFIT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:713-993-6053
Mailing Address - Street 1:PO BOX 66791
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77266-6791
Mailing Address - Country:US
Mailing Address - Phone:713-993-6053
Mailing Address - Fax:866-810-8005
Practice Address - Street 1:800 WILCREST DR STE 213
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-1360
Practice Address - Country:US
Practice Address - Phone:713-993-6053
Practice Address - Fax:866-810-8005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-18
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX401074601Medicaid
TXMEDICAREOther817625