Provider Demographics
NPI:1598795916
Name:WALMSLEY, GEORGE STORM (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:STORM
Last Name:WALMSLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8608 N HIGHWAY 146
Mailing Address - Street 2:SUITE 600
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77523-7505
Mailing Address - Country:US
Mailing Address - Phone:832-556-6936
Mailing Address - Fax:832-573-9218
Practice Address - Street 1:8608 N HIGHWAY 146
Practice Address - Street 2:SUITE 600
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77523-7505
Practice Address - Country:US
Practice Address - Phone:832-556-6936
Practice Address - Fax:832-573-9218
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2016-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1329207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8FT463OtherBLUE CROSS BLUE SHIELD
TX038267305Medicaid
TX8AJ093OtherBLUECROSS BLUESHIELD
TX8DV163OtherBLUE CROSS BLUE SHIELD
TXP01557072OtherRR MEDICARE
TXB27407Medicare UPIN
TX038267305Medicaid
TXP01557072OtherRR MEDICARE
TX296722YMVQMedicare PIN