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Organization
PRIMARY CARE OF VAN VLECK, PLLC
Active
Organization
PRIMARY CARE OF VAN VLECK, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMED ATIQ DADA MD (OWNER)
(979) 245-2421
Entity
Organization
Contact information
Practice address
170 S 4TH ST, #2, VAN VLECK, TX 77482
(979) 245-2421
(979) 245-6263
Mailing address
PO BOX 2660, BAY CITY, TX 77404-2660
(979) 245-2421
(979) 245-6263
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RN0300X
Nephrology Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/20/2022
Last updated
05/23/2022
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