Organization Active NPI

Vascular Institute of Houston PLLC

  • Vascular Surgery Physician
  • Houston, TX
National Provider Identifier
1770107856
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VASCULAR INSTITUTE OF HOUSTON PLLC
Practice address
7515 Main St Ste 100
Houston, TX 77030-4549
Phone
(832) 777-7570
Fax
(281) 709-2575
NPI assigned
Jun 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Authorized official

Name
Bonnie Potter
Title
Credentialing Manager
Phone
(916) 846-9454

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

7515 Main St Ste 100
Houston, TX 77030-4549

Mailing address

635 Anderson Rd Ste 4
Davis, CA 95616-3505
Phone (832) 777-7570

Other practice location 1

17215 Red Oak Dr Ste 110
Houston, TX 77090-2611
Phone (832) 777-7570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200814000528 TX Part B Supplier - Clinic/Group Practice 5496171902 Receives reassigned benefits from 5 practitioners
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Locations

815 Brazos St
Ste 500
Austin, TX 78701
Phone (773) 875-1272

17215 Red Oak Dr
Ste 110
Houston, TX 77090
Phone (281) 537-7784

17115 Red Oak Dr
#113
Houston, TX 77090

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AICDCD

Practitioners & affiliated clinicians

Practitioners 5

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": "1591142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1770107856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 ANDERSON RD STE 4",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956163505",
            "telephone_number": "832-777-7570",
            "fax_number": "281-709-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7515 MAIN ST STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304549",
            "telephone_number": "832-777-7570",
            "fax_number": "281-709-2575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17215 Red Oak Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770902611",
            "country_code": "US",
            "telephone_number": "832-777-7570",
            "fax_number": "281-709-2575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VASCULAR INSTITUTE OF HOUSTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-03",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "916-846-9454"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Nov 10, 2025; 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.