Provider Demographics
NPI:1679660237
Name:VASUT, BRENT J (MD)
Entity type:Individual
Prefix:
First Name:BRENT
Middle Name:J
Last Name:VASUT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:211 HIGHLAND CROSS DR
Mailing Address - Street 2:SUITE 275
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-1733
Mailing Address - Country:US
Mailing Address - Phone:281-784-1500
Mailing Address - Fax:281-784-1522
Practice Address - Street 1:211 HIGHLAND CROSS DR
Practice Address - Street 2:SUITE 275
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-1733
Practice Address - Country:US
Practice Address - Phone:281-784-1500
Practice Address - Fax:281-784-1522
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2010-05-07
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Provider Licenses
StateLicense IDTaxonomies
TXL2724207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142045701Medicaid
TX135867310Medicaid
TX1679660237OtherTRICARE SOUTH
TX1679660237OtherBCBSTX
TX8BX676OtherBCBSTX
TXP00683573Medicare PIN
TX142045701Medicaid
TX1679660237OtherBCBSTX
TX1679660237OtherTRICARE SOUTH