Provider Demographics
NPI:1598879405
Name:DEPARTMENT OF VETERANS AFFAIRS
Entity Type:Organization
Organization Name:DEPARTMENT OF VETERANS AFFAIRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSES ASSITANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:FLOYD
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:713-791-1414
Mailing Address - Street 1:FLOYD YOUNG
Mailing Address - Street 2:107-14TH STREET
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550
Mailing Address - Country:US
Mailing Address - Phone:409-762-0398
Mailing Address - Fax:
Practice Address - Street 1:107 14TH ST
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-2607
Practice Address - Country:US
Practice Address - Phone:409-762-0398
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX376K00000XOtherTAXONOMY