Provider Demographics
NPI:1457606345
Name:VISTA PHYSICIANS, P.A.
Entity Type:Organization
Organization Name:VISTA PHYSICIANS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUSINESS FINANCIAL SERV
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-378-3000
Mailing Address - Street 1:PO BOX 5917
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77508-5917
Mailing Address - Country:US
Mailing Address - Phone:713-378-3180
Mailing Address - Fax:713-943-2323
Practice Address - Street 1:4301 VISTA RD
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-2117
Practice Address - Country:US
Practice Address - Phone:713-378-3180
Practice Address - Fax:713-943-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty