A problem like that usually arises whenever GPUs tend to get close to overheating, thus messing up its ability to determine what texture goes where.
Have you overclocked your graphics card any? If not, is it well ventilated?
If temps aren't the issue, then I really don't know from there. All I know is that it's something to do with your GPU and NOT Fallout New Vegas.
I DISCOVERED THE ISSUE!!!
It was a corrupt installl...when i was downloading installing it through steam my computer randomly rebooted. Thus halting the dling/installing process and somehow messing up the textures and even putting red triangles with exclamation points through them...all i did was uninstall and reinstall and works perfect.
also because i have a gtx 260, set water setting to medium and no lag...
THIS GAME IS AMAZING!!!