Provider Demographics
NPI:1184919110
Name:VAN ACHT, VINCENT LEONARD (MD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:LEONARD
Last Name:VAN ACHT
Suffix:
Gender:M
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:PO BOX 5409
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-5409
Mailing Address - Country:US
Mailing Address - Phone:325-793-5237
Mailing Address - Fax:325-793-5239
Practice Address - Street 1:1665 ANTILLEY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5265
Practice Address - Country:US
Practice Address - Phone:325-793-5237
Practice Address - Fax:325-793-5239
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ1045207Q00000X
NC172869390200000X
MDD91255207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program