Organization · NPI-2
Advanced Vein & Vascular Associates
· Dallas, TX
NPI number1497062830
StatusActive
Last updated in NPPESJul 24, 2024
Details
- NPI
- 1497062830
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Vein & Vascular Associates
- Organization subpart
- No
- Enumeration date
- Sep 7, 2010
- Certification date
- Jul 24, 2024
- Last updated
- Jul 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0129X | K0853 | TX | Yes | |
| 261QM2500X | Clinic/Center, Medical Specialty | – | – |
Practice location
7515 Greenville Ave Ste 706Dallas, TX 75231-3885
Phone 469-547-1142 · Fax 469-547-1162
Mailing address
7515 Greenville Ave Ste 706Dallas, TX 75231-3885
Phone 469-547-1142 · Fax 469-547-1162
Authorized official
Humam Bassam Kakish
Owner
4695471142
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