MEDICARE: MR. LARRY JOSEPH TURNBOUGH R.N.

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	163W00000X	Registered Nurse	133879	MO

General Provider Information

NPI Number	:	1558385005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LARRY JOSEPH TURNBOUGH R.N.

Provider Business Mailing Address
First Line	:	3305 IRISH SHORES LN
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7923
Country	:	US
Telephone Number	:	281-412-4277
Fax Number	:

Provider Business Practice Location Address
First Line	:	2202 HOLCOMBE BLVD
Second Line	:	MICHAEL E. DEBAKEY VAMC
City	:	HOUSTON
State	:	TX
Zip	:	77030
Country	:	US
Telephone Number	:	713-791-1414
Fax Number	:

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

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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