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NPI Code Detail

MEDICARE: MR. VAL D WASHINGTON PTA

MEDICARE: MR. VAL D WASHINGTON PTA
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
1314000000XSkilled Nursing Facility2041689TX

General Provider Information

NPI Number : 1215129663
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VAL D WASHINGTON PTA
Provider Business Mailing Address
First Line : 8550 WOODWAY DR
Second Line :
City : HOUSTON
State : TX
Zip : 77063-2482
Country : US
Telephone Number : 832-496-2580
Fax Number :
Provider Business Practice Location Address
First Line : 8550 WOODWAY DR
Second Line :
City : HOUSTON
State : TX
Zip : 77063-2482
Country : US
Telephone Number : 832-496-2580
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2007
Last Update Date : 08/09/2007

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