Provider Demographics
NPI:1619971546
Name:RICHARD K. VANIK, MD PA
Entity Type:Organization
Organization Name:RICHARD K. VANIK, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:VANIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-981-7900
Mailing Address - Street 1:7777 SW FWY #500
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074
Mailing Address - Country:US
Mailing Address - Phone:713-981-7900
Mailing Address - Fax:713-774-5119
Practice Address - Street 1:7777 SW FWY #500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074
Practice Address - Country:US
Practice Address - Phone:713-981-7900
Practice Address - Fax:713-774-5119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7365174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1619971546OtherNPI
C22920Medicare UPIN
TX1619971546OtherNPI