Provider Demographics
NPI:1912914052
Name:VLADA, GHEORGHE (LSA)
Entity Type:Individual
Prefix:
First Name:GHEORGHE
Middle Name:
Last Name:VLADA
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2918 SKYPARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2032
Mailing Address - Country:US
Mailing Address - Phone:713-478-3865
Mailing Address - Fax:281-679-1435
Practice Address - Street 1:2918 SKYPARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2032
Practice Address - Country:US
Practice Address - Phone:713-478-3865
Practice Address - Fax:281-679-1435
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00053246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0061JROtherBC/BS