Healthcare Provider Details

I. General information

NPI: 1609978204
Provider Name (Legal Business Name): VETERANS AFFAIRS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2002 HOLCOMBE BLVD
HOUSTON TX
77030-4211
US

IV. Provider business mailing address

11802 WHITE WATER BAY DR
PEARLAND TX
77584-8778
US

V. Phone/Fax

Practice location:
  • Phone: 713-791-1414
  • Fax:
Mailing address:
  • Phone: 713-436-1253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2865M2000X
TaxonomyMilitary General Acute Care Hospital
License Number64769
License Number StateTX

VIII. Authorized Official

Name: MRS. MARY ROSE AMISTOSO
Title or Position: RESPIRATORY
Credential: CRT
Phone: 713-791-1414