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General NPI Number Information
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NPI Number | 1043435357
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Entity Type | Organization
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Legal Business Name | MICHAEL E. DEBAKEY VA MEDICAL CENTER
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18307 FERNBLUFF DR
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City | SPRING
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State | TX
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Zip | 77379-4034
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Country | US
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Telephone | 832-298-3338
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Fax |
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Provider Business Mailing Address
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Address Line | 18307 FERNBLUFF DR
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City | SPRING
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State | TX
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Zip | 77379-4034
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Country | US
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Telephone | 832-298-3338
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Fax |
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Authorized Official
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Title or Position | RADIOLOGICAL TECHNOLOGIST
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Name | MARTIN GAJDUSEK
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Credential |
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Telephone | 713-791-1414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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