Organization Active NPI

Vanguard Spine & Sport, PLLC

  • Family Medicine Physician
  • Houston, TX
National Provider Identifier
1407360100
Registry record updated May 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VANGUARD SPINE & SPORT, PLLC
Practice address
8800 Katy Fwy Ste 201
Houston, TX 77024-1645
Phone
(832) 831-8656
Fax
(832) 831-8674
NPI assigned
Nov 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lance IguessNPI 1821362971
Title
Owner
Phone
(832) 831-8656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

8800 Katy Fwy Ste 201
Houston, TX 77024-1645

Mailing address

8800 Katy Fwy Ste 201
Houston, TX 77024-1645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180119000450 TX Part B Supplier - Clinic/Group Practice 3971862921 Receives reassigned benefits from 6 practitioners
Practice locations: Houston, TX
O20180216002067 TX DME Supplier - Physician - Family Practice 3971862921 Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

3303 Oakwell Ct
San Antonio, TX 78218

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714694400000",
    "number": "1407360100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 KATY FWY STE 201",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 KATY FWY STE 201",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770241645",
            "telephone_number": "832-831-8656",
            "fax_number": "832-831-8674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANGUARD SPINE & SPORT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2024-05-03",
        "certification_date": "2024-05-03",
        "status": "A",
        "authorized_official_last_name": "IGUESS",
        "authorized_official_first_name": "LANCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-831-8656"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.