Provider Demographics
NPI:1306175138
Name:VINING, DANNY (PMHNP)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:
Last Name:VINING
Suffix:
Gender:M
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6514 HIGHWAY 90A STE 101
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-2120
Mailing Address - Country:US
Mailing Address - Phone:281-915-2370
Mailing Address - Fax:281-791-2374
Practice Address - Street 1:6514 HIGHWAY 90A STE 101
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-2120
Practice Address - Country:US
Practice Address - Phone:281-790-2370
Practice Address - Fax:281-790-2374
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR855135363LP0808X
TX1043662363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02339353Medicaid