Provider Demographics
NPI:1144588740
Name:VIP HEALTH SERVICES, LLC.
Entity type:Organization
Organization Name:VIP HEALTH SERVICES, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAMIDREZA
Authorized Official - Middle Name:
Authorized Official - Last Name:IRANMANESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-360-7502
Mailing Address - Street 1:2601 W LAKE HOUSTON PKWY
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-5222
Mailing Address - Country:US
Mailing Address - Phone:281-360-7502
Mailing Address - Fax:281-360-0587
Practice Address - Street 1:2601 W LAKE HOUSTON PKWY
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-5222
Practice Address - Country:US
Practice Address - Phone:281-360-7502
Practice Address - Fax:281-360-0587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN3749302R00000X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No302R00000XManaged Care OrganizationsHealth Maintenance Organization