Provider Demographics
NPI:1790921401
Name:MICHAEL E. DEBAKEY VETERANS AFFAIRS
Entity Type:Organization
Organization Name:MICHAEL E. DEBAKEY VETERANS AFFAIRS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:JYOTHI
Authorized Official - Middle Name:R
Authorized Official - Last Name:NELAPJR
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:281-564-7774
Mailing Address - Street 1:10434 HUNTINGTON WOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-3722
Mailing Address - Country:US
Mailing Address - Phone:281-564-7774
Mailing Address - Fax:
Practice Address - Street 1:10434 HUNTINGTON WOOD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-3722
Practice Address - Country:US
Practice Address - Phone:281-564-7774
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherMICHAEL E. DEBAKEY VAMC