Provider Demographics
NPI:1144334376
Name:DEPARTMENT OF VETERANS AFFAIRS
Entity type:Organization
Organization Name:DEPARTMENT OF VETERANS AFFAIRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSALVA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-665-6824
Mailing Address - Street 1:3027 BROADMEAD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-3817
Mailing Address - Country:US
Mailing Address - Phone:713-665-6824
Mailing Address - Fax:
Practice Address - Street 1:3027 BROADMEAD DRIVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025-3817
Practice Address - Country:US
Practice Address - Phone:713-665-6824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX602051273R00000X, 283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered273R00000XHospital UnitsPsychiatric Unit
Not Answered283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX602051Other163WPO809X