Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | P3094 | TX |
NPI | 1013133768 |
---|---|
Provider Name | Dr. Olga Waln |
First Address | Houston, TX 77030-2761 |
Second Address | Houston, TX 77030-2761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2007 |
Last Update Date | 06/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8GS986 | BCBS (01) | TX |
P01483197 | RR MEDICARE (01) | TX |