Provider Demographics
NPI:1902429780
Name:L.D. WALTER GROUP
Entity Type:Organization
Organization Name:L.D. WALTER GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LARONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-330-8011
Mailing Address - Street 1:3334 FM 1092 RD STE 445
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2287
Mailing Address - Country:US
Mailing Address - Phone:713-330-8011
Mailing Address - Fax:
Practice Address - Street 1:3334 FM 1092 RD STE 445
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2287
Practice Address - Country:US
Practice Address - Phone:713-330-8011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:L.D. WALTER GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-27
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy