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General NPI Number Information
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NPI Number | 1659754851
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Entity Type | Individual
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Provider Name | WALTER ANDRES CAMARGO JORDAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2015
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Last Update Date | 05/29/2019
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Provider Practice Location Address
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Address Line | 6431 FANNIN ST STE 7.044
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City | HOUSTON
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State | TX
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Zip | 77030-1501
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Country | US
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Telephone | 832-325-7080
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Fax | 713-512-2239
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Provider Business Mailing Address
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Address Line | 6431 FANNIN ST STE 7.044
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City | HOUSTON
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State | TX
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Zip | 77030-1501
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Country | US
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Telephone | 832-325-7080
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Fax | 713-512-2239
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP10054911
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License Number State | TX
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