Healthcare Provider Details

I. General information

NPI: 1710238704
Provider Name (Legal Business Name): BARBARA JANE WALDRUP RESPIRATORY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2012
Last Update Date: 10/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15313 KINGFIELD DR
HOUSTON TX
77084-1410
US

IV. Provider business mailing address

15313 KINGFIELD DR
HOUSTON TX
77084-1410
US

V. Phone/Fax

Practice location:
  • Phone: 281-859-9369
  • Fax: 281-859-9369
Mailing address:
  • Phone: 281-859-9369
  • Fax: 281-859-9369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number65603
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2278E1000X
TaxonomyEducational Certified Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2278G1100X
TaxonomyGeneral Care Certified Respiratory Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License Number65603
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code2278P3800X
TaxonomyPalliative/Hospice Certified Respiratory Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2278P4000X
TaxonomyPatient Transport Certified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: