Individual
VIRGINIA ALICIA PITTMAN-WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3003 SOUTH LOOP WEST, SUITE 210, HOUSTON, TX 77054
(210) 416-6000
Mailing address
818 W 41ST STREET, HOUSTON, TX 77018
(210) 416-6000
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
K5666
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420551001
—
TX
Enumeration date
05/12/2006
Last updated
12/15/2023
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