# INTERVENTIONAL, VASCULAR & DIAGNOSTIC ASSOCIATES, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003188376
- **Authorized official:** RAJIV THAKUR MD (PRESIDENT)
- **Authorized official phone:** (713) 795-4884

## Contact information

- **Practice address:** 16 CRESTWOOD DR, HOUSTON, TX 77007-7007
- **Practice address phone:** (713) 795-4884
- **Mailing address:** PO BOX 301103, HOUSTON, TX 77230-1103
- **Mailing address phone:** (713) 795-4884
- **Mailing address fax:** (713) 383-4470

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085N0904X | Nuclear Radiology Physician | — | NULL | — |
| 2085N0904X | Nuclear Radiology Physician | — | — | — |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | K9433 | TX | Yes |

## Other

- **Enumeration date:** 02/02/2012
- **Last updated:** 02/02/2012