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Individual

DR. KENNETH RAY VANOWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4141 VISTA RD, PASADENA, TX 77504-2113
(713) 947-3100
Mailing address
4141 VISTA RD, PASADENA, TX 77504-2113
(713) 947-3100
(713) 947-6103

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
01058864A
IN
2084N0400X
Neurology Physician
04-34475
KS
2084N0400X
Neurology Physician
2007007216
MO
2084N0400X
Neurology Physician
Primary
T0028
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200533040A
KS
05
207435009
MO
01
P00427020
MEDICARE RR PIN
Enumeration date
02/24/2007
Last updated
09/25/2024
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