Provider Demographics
NPI:1942312509
Name:MICHAEL DEBAKEY MEDICAL CENTER
Entity Type:Organization
Organization Name:MICHAEL DEBAKEY MEDICAL CENTER
Other - Org Name:VETERAN AFFIAR
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:NURSING ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATINA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:713-791-1414
Mailing Address - Street 1:12230 SUNSET MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-6661
Mailing Address - Country:US
Mailing Address - Phone:832-443-5771
Mailing Address - Fax:
Practice Address - Street 1:12230 SUNSET MEADOW LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-6661
Practice Address - Country:US
Practice Address - Phone:832-443-5771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit