Healthcare Provider Details

I. General information

NPI: 1124050596
Provider Name (Legal Business Name): WALTER R HOLMSTEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7545 S BRAESWOOD BLVD
HOUSTON TX
77071-1423
US

IV. Provider business mailing address

7545 S BRAESWOOD BLVD
HOUSTON TX
77071-1423
US

V. Phone/Fax

Practice location:
  • Phone: 713-777-3131
  • Fax: 713-777-5544
Mailing address:
  • Phone: 713-777-3131
  • Fax: 713-777-5544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL8734
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberL8734
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: