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Individual

DR. VINCENT C PHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
16811 SOUTHWEST FWY, SUGAR LAND, TX 77479
(281) 690-4678
(281) 565-8808
Mailing address
16811 SOUTHWEST FWY, SUGAR LAND, TX 77479-4728
(281) 690-4678
(281) 565-8808

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
K1278
TX
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
K1278
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
144768201
TX
05
144768202
TX
05
144768203
TX
05
144768204
TX
05
144768205
TX
05
144768206
TX
05
144768207
TX
01
2630736
AETNA
TX
01
610119705
US DEPT OF LABOR
TX
01
8BP174
BLUE CROSS BLUE SHIELD
TX
01
P00732726
RAILROAD MEDICARE
TX
01
P01055722
RR MEDICARE
TX
Enumeration date
08/31/2006
Last updated
06/10/2019
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