Provider Demographics
NPI:1508584426
Name:VU, JAYLENE
Entity type:Individual
Prefix:
First Name:JAYLENE
Middle Name:
Last Name:VU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77001-0207
Mailing Address - Country:US
Mailing Address - Phone:281-829-2000
Mailing Address - Fax:888-355-2052
Practice Address - Street 1:18885 KATY FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1103
Practice Address - Country:US
Practice Address - Phone:281-829-2000
Practice Address - Fax:888-355-2052
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA18905363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical