Provider Demographics
NPI:1629403142
Name:V TECH MEDICAL CENTER INC
Entity Type:Organization
Organization Name:V TECH MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VASILIY
Authorized Official - Middle Name:G
Authorized Official - Last Name:YASENYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-793-0791
Mailing Address - Street 1:7457 HARWIN DR STE 137
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2018
Mailing Address - Country:US
Mailing Address - Phone:281-793-0791
Mailing Address - Fax:
Practice Address - Street 1:7457 HARWIN DR STE 137
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2018
Practice Address - Country:US
Practice Address - Phone:281-793-0791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty