Provider Demographics
NPI:1376541789
Name:OHARA, WALTER W (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:W
Last Name:OHARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1401
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-5200
Mailing Address - Fax:713-793-7428
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1401
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-5200
Practice Address - Fax:713-793-7428
Is Sole Proprietor?:No
Enumeration Date:2005-07-09
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0429755208G00000X
TXN8699208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1376541789OtherBLUE CROSS BLUE SHIELD
TX280663002Medicaid
KS100422750AMedicaid
TX280663001Medicaid
TX280663004Medicaid
TX280663003Medicaid
TXP01301598OtherRR MEDICARE
TXTXB123954Medicare PIN
TXP01301598OtherRR MEDICARE
TX280663001Medicaid
TXTXB124055Medicare PIN
TXTXB145698Medicare PIN