Healthcare Provider Details

I. General information

NPI: 1528137320
Provider Name (Legal Business Name): VA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 HOLCOMBE BLVD
HOUSTON TX
77030-4211
US

IV. Provider business mailing address

9502 GOLDENGLADE CIR
HOUSTON TX
77064-5265
US

V. Phone/Fax

Practice location:
  • Phone: 713-794-7563
  • Fax:
Mailing address:
  • Phone: 281-955-8006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. WARREN D. TAYLOR
Title or Position: POYSOMNOGRAPHIC TECHNOLOGIST
Credential:
Phone: 713-794-7556