# HOUSTON VEIN AND VASCULAR PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Houston vein and vascular
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114693504
- **Authorized official:** AMELIA GOODRUM (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (479) 242-2562

## Contact information

- **Practice address:** 6565 WEST LOOP S STE 110, BELLAIRE, TX 77401-3505
- **Practice address phone:** (713) 242-3000
- **Mailing address:** 5707 JENNY LIND RD, FORT SMITH, AR 72908-7435
- **Mailing address phone:** (479) 452-9416
- **Mailing address fax:** (479) 242-1990

## Taxonomy

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

## Other

- **Enumeration date:** 08/17/2021
- **Last updated:** 01/17/2025