Provider Demographics
NPI:1386287514
Name:PHAN, VI (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:VI
Middle Name:
Last Name:PHAN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 FANNIN ST STE 801
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-5870
Mailing Address - Country:US
Mailing Address - Phone:713-790-0841
Mailing Address - Fax:713-790-9663
Practice Address - Street 1:5115 FANNIN ST STE 801
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-5870
Practice Address - Country:US
Practice Address - Phone:713-790-0841
Practice Address - Fax:713-790-9663
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143648363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily