Basic Information
Provider Information | |||||||||
NPI: | 1689816894 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | VPA OF TEXAS PLLC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | PO BOX 1500 | ||||||||
Address2: |   | ||||||||
City: | NOVI | ||||||||
State: | MI | ||||||||
PostalCode: | 483761500 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2483240700 | ||||||||
FaxNumber: | 2483241477 | ||||||||
Practice Location | |||||||||
Address1: | 7800 SHOAL CREEK BLVD | ||||||||
Address2: | STE 120W | ||||||||
City: | AUSTIN | ||||||||
State: | TX | ||||||||
PostalCode: | 787571098 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5124078880 | ||||||||
FaxNumber: | 5124078681 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/02/2009 | ||||||||
LastUpdateDate: | 03/15/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | SASSER | ||||||||
AuthorizedOfficialFirstName: | WILLIAM | ||||||||
AuthorizedOfficialMiddleName: | F | ||||||||
AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
AuthorizedOfficialTelephone: | 2488246600 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: | DR. | ||||||||
AuthorizedOfficialNameSuffix: | JR. | ||||||||
AuthorizedOfficialCredential: | MD | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X |   | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.