Provider Demographics
NPI:1518339126
Name:WALD, ORI (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:ORI
Middle Name:
Last Name:WALD
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6607 KELVIN DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1925
Mailing Address - Country:US
Mailing Address - Phone:832-570-6456
Mailing Address - Fax:
Practice Address - Street 1:6620 MAIN ST STE 1325
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2332
Practice Address - Country:US
Practice Address - Phone:713-798-6376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ81968208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)