Healthcare Provider Details

I. General information

NPI: 1790921401
Provider Name (Legal Business Name): MICHAEL E. DEBAKEY VETERANS AFFAIRS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2008
Last Update Date: 12/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10434 HUNTINGTON WOOD DR
HOUSTON TX
77099-3722
US

IV. Provider business mailing address

10434 HUNTINGTON WOOD DR
HOUSTON TX
77099-3722
US

V. Phone/Fax

Practice location:
  • Phone: 281-564-7774
  • Fax:
Mailing address:
  • Phone: 281-564-7774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. JYOTHI R NELAPJR
Title or Position: SOCIAL WORKER
Credential: LMSW
Phone: 281-564-7774