Active NPI
Ventzislav D Vanguelov, M.D.
- Obstetrics & Gynecology Physician
- San Juan, TX
National Provider Identifier
1457359333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- L9946
- Practice address
- 806 W 3Rd St
San Juan, TX 78589 - Phone
- (956) 787-0787
- NPI assigned
- Jul 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | L9946 | TX | Primary |
Addresses
Primary practice location
806 W 3Rd St
San Juan, TX 78589
Mailing address
PO Box 1689
Pharr, TX 78577-1630
Phone (956) 787-0787
Other practice location 1
611 N Bryan Rd
Mission, TX 78572-6285
Phone (956) 580-3303
Other practice location 2
801 W 1st St
San Juan, TX 78589-2276
Phone (956) 787-8915
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 173021001 | Medicaid | TX | |
| TXB133201 | Other | TX | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535673600000",
"number": "1457359333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1689",
"city": "PHARR",
"state": "TX",
"postal_code": "785771630",
"telephone_number": "956-787-0787",
"fax_number": "956-787-2021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "806 W 3RD ST",
"city": "SAN JUAN",
"state": "TX",
"postal_code": "78589",
"telephone_number": "956-787-0787"
}
],
"practiceLocations": [
{
"address_1": "611 N Bryan Rd",
"address_purpose": "LOCATION",
"city": "Mission",
"state": "TX",
"postal_code": "785726285",
"country_code": "US",
"telephone_number": "956-580-3303",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "801 W 1st St",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "TX",
"postal_code": "785892276",
"country_code": "US",
"telephone_number": "956-787-8915",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANGUELOV",
"first_name": "VENTZISLAV",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-13",
"last_updated": "2018-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "TX",
"license": "L9946",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "173021001",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "TXB133201",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Juan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.