Individual
DR. MICKEY JAMES VIATOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6411 FANNIN ST, HOUSTON, TX 77030-1501
(713) 500-7878
Mailing address
3715 ROYLENE CT, DICKINSON, TX 77539-6412
(281) 337-3784
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
014805
LA
208000000X
Pediatrics Physician
N2871
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1313238
—
LA
05
—
183764305
—
TX
01
—
183764306
CSHCN
TX
01
—
8X6088
BCBSTX
TX
Enumeration date
06/14/2006
Last updated
08/24/2009
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