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General NPI Number Information
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NPI Number | 1215129663
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Entity Type | Individual
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Provider Name | VAL D WASHINGTON PTA
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Gender | Male
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 08/09/2007
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Provider Practice Location Address
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Address Line | 8550 WOODWAY DR
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City | HOUSTON
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State | TX
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Zip | 77063-2482
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Country | US
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Telephone | 832-496-2580
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Fax |
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Provider Business Mailing Address
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Address Line | 8550 WOODWAY DR
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City | HOUSTON
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State | TX
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Zip | 77063-2482
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Country | US
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Telephone | 832-496-2580
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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 | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 2041689
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License Number State | TX
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