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General NPI Number Information
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NPI Number | 1528314499
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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 | 07/30/2012
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Last Update Date | 07/30/2012
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Provider Practice Location Address
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Address Line | 3109 W OAKS BLVD
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City | PEARLAND
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State | TX
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Zip | 77584-8395
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Country | US
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Telephone | 713-344-0804
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Fax |
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Provider Business Mailing Address
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Address Line | 3109 W OAKS BLVD
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City | PEARLAND
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State | TX
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Zip | 77584-8395
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Country | US
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Telephone | 713-344-0804
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Fax |
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Authorized Official
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Title or Position | NURSE MANAGER
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Name | MRS. MICHELLE BATISTE
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Credential | RN
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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 | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 770992
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License Number State | LA
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