Basic Information
| Provider Information | |||||||||
| NPI: | 1861602559 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VINTON | ||||||||
| FirstName: | TONIA | ||||||||
| MiddleName: | YEE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 845347 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752847208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146452900 | ||||||||
| FaxNumber: | 2146452915 | ||||||||
| Practice Location | |||||||||
| Address1: | 8230 WALNUT HILL LN STE 204 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752314408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146452900 | ||||||||
| FaxNumber: | 2146452915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2007 | ||||||||
| LastUpdateDate: | 09/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | N4214 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 207096301 | 05 | TX | MEDICAID | BP1-0026175 | 01 | INSTITUTIONAL PERMIT | OTHER | 2070963-08 | 05 | TX | MEDICAID |