Organization
VA OUTPATIIENT CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA KYLE (PHCY MANG)
(713) 794-7223
Entity
Organization
Contact information
Practice address
3420 VETERANS CIR, BEAUMONT, TX 77707-2552
(409) 981-8570
(409) 981-8569
Mailing address
PO BOX 300408, HOUSTON, TX 77230-0408
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4547913
OTHER ID NUMBER
—
Enumeration date
04/03/2008
Last updated
04/03/2008
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