Provider Demographics
NPI:1245843473
Name:SOY, VANNICA (FNP-C)
Entity type:Individual
Prefix:
First Name:VANNICA
Middle Name:
Last Name:SOY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18422 MAPLE MILL DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4523
Mailing Address - Country:US
Mailing Address - Phone:832-790-2491
Mailing Address - Fax:
Practice Address - Street 1:27150 HIGHWAY 290 STE 100
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-7224
Practice Address - Country:US
Practice Address - Phone:832-653-3300
Practice Address - Fax:832-653-6407
Is Sole Proprietor?:No
Enumeration Date:2020-08-27
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1009473207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology