Organization
RUSSELL C VANBIBER MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL C VANBIBER III M.D. (PHYSICIAN)
(832) 769-3313
Entity
Organization
Contact information
Practice address
2500 FONDREN RD, SUITE NUMBER 255, HOUSTON, TX 77063-2308
(832) 769-3313
(832) 769-3307
Mailing address
2500 FONDREN RD, SUITE NUMBER 255, HOUSTON, TX 77063-2308
(832) 769-3313
(832) 769-3307
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
G5728
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TXB164779
MEDICARE
TX
Enumeration date
10/07/2015
Last updated
10/07/2015
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