Provider Demographics
NPI:1043399322
Name:WATKINS, HERBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:L
Last Name:WATKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 WESTMONT DR STE 425
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-4358
Mailing Address - Country:US
Mailing Address - Phone:713-453-4395
Mailing Address - Fax:713-453-4397
Practice Address - Street 1:1140 WESTMONT DR STE 425
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-4358
Practice Address - Country:US
Practice Address - Phone:713-453-4395
Practice Address - Fax:713-453-4397
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5053208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135715412Medicaid
TX135715406Medicaid
TX135715413Medicaid
TX8B5400Medicare PIN
TX85Z510Medicare PIN
TX8B5399Medicare PIN