Provider Demographics
NPI: | 1710238704 |
---|---|
Name: | WALDRUP, BARBARA JANE (RESPIRATORY) |
Entity Type: | Individual |
Prefix: | MISS |
First Name: | BARBARA |
Middle Name: | JANE |
Last Name: | WALDRUP |
Suffix: | |
Gender: | F |
Credentials: | RESPIRATORY |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 15313 KINGFIELD DR |
Mailing Address - Street 2: | |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77084-1410 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 281-859-9369 |
Mailing Address - Fax: | 281-859-9369 |
Practice Address - Street 1: | 15313 KINGFIELD DR |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77084-1410 |
Practice Address - Country: | US |
Practice Address - Phone: | 281-859-9369 |
Practice Address - Fax: | 281-859-9369 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2012-10-01 |
Last Update Date: | 2012-10-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 65603 | 227800000X, 2278H0200X |
2278E1000X, 2278G1100X, 2278P3800X, 2278P4000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 227800000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | |
No | 2278E1000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Educational |
No | 2278G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | General Care |
No | 2278H0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Home Health |
No | 2278P3800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Palliative/Hospice |
No | 2278P4000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Patient Transport |