Provider Demographics
NPI:1497094841
Name:VANGUARD MEDREVIEW INC.
Entity Type:Organization
Organization Name:VANGUARD MEDREVIEW INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:JENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-602-1478
Mailing Address - Street 1:2732 PARKCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-1015
Mailing Address - Country:US
Mailing Address - Phone:817-602-1478
Mailing Address - Fax:817-632-2619
Practice Address - Street 1:2732 PARKCHESTER DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-1015
Practice Address - Country:US
Practice Address - Phone:817-602-1478
Practice Address - Fax:817-632-2619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty