Healthcare Provider Details

I. General information

NPI: 1033229778
Provider Name (Legal Business Name): VA HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8222 LONE BRIDGE LN
HUMBLE TX
77338-1726
US

IV. Provider business mailing address

8222 LONE BRIDGE LN
HUMBLE TX
77338-1726
US

V. Phone/Fax

Practice location:
  • Phone: 281-446-8470
  • Fax:
Mailing address:
  • Phone: 281-446-8470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number63094
License Number StateTX

VIII. Authorized Official

Name: MRS. PAULA LE'CHELLE BRANDYBERG-IKWUAGWU
Title or Position: REGISTERED RESPIRATORY THERAPIST
Credential: B.S., RRT
Phone: 281-446-8470