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General NPI Number Information
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NPI Number | 1093020505
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Entity Type | Individual
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Provider Name | WALES THOTTATHIKUNNATH GEORGE M.D
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Gender | Male
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 2800 S MACGREGOR WAY
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City | HOUSTON
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State | TX
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Zip | 77021-1032
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Country | US
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Telephone | 713-741-3830
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 S MACGREGOR WAY
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City | HOUSTON
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State | TX
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Zip | 77021-1032
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Country | US
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Telephone | 713-741-3830
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD461098
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | V9904
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 201400956
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101256576
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License Number State | VA
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