Organization
VINCENT VIRGADAMO, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENZO VIRGADAMO M.D. (PRESIDENT)
(713) 795-0055
Entity
Organization
Contact information
Practice address
6624 FANNIN ST, SUITE 2160, HOUSTON, TX 77030-2312
(713) 795-0055
(713) 795-4384
Mailing address
6624 FANNIN ST, SUITE 2160, HOUSTON, TX 77030-2312
(713) 795-0055
(713) 795-4384
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039WD
BCBS
—
01
—
10023740
AMERIGROUP
TX
01
—
2227346
BLUE LINK
TX
05
—
281559901
—
TX
01
—
4270229
AETNA
TX
Enumeration date
01/27/2010
Last updated
06/21/2016
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