MEDICARE: HAROLD JOSE WALTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	K3873	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	87Z036	OTHER	TX	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194726273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAROLD JOSE WALTON M.D.

Provider Business Mailing Address
First Line	:	11452 SPACE CENTER BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77059-3599
Country	:	US
Telephone Number	:	713-486-6200
Fax Number	:	713-486-6294

Provider Business Practice Location Address
First Line	:	11452 SPACE CENTER BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77059-3599
Country	:	US
Telephone Number	:	713-486-6200
Fax Number	:	713-486-6294

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	03/14/2023

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