# VINTAGE HEALTHCARE, INC.

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

## Provider details

- **NPI number:** 1114251634
- **Authorized official:** MARLA E OWUAMA (ADMINISTRATOR)
- **Authorized official phone:** (281) 739-3825

## Contact information

- **Practice address:** 8700 COMMERCE PARK DR, 228D, HOUSTON, TX 77036-7497
- **Practice address phone:** (281) 739-3825
- **Mailing address:** 8700 COMMERCE PARK DR, 228D, HOUSTON, TX 77036-7497
- **Mailing address phone:** (281) 739-3825

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 3416L0300X | Land Ambulance | 1000462 | TX | — |

## Other

- **Enumeration date:** 09/30/2009
- **Last updated:** 08/18/2010