Provider Demographics
NPI:1871609065
Name:VETERANS AFFAIRS HOSPITAL
Entity type:Organization
Organization Name:VETERANS AFFAIRS HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:MAFFEI
Authorized Official - Suffix:
Authorized Official - Credentials:MPAS, PA-C
Authorized Official - Phone:903-583-2111
Mailing Address - Street 1:508 RIVERSIDE CT
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3658
Mailing Address - Country:US
Mailing Address - Phone:214-725-4818
Mailing Address - Fax:
Practice Address - Street 1:1201 E 9TH ST
Practice Address - Street 2:
Practice Address - City:BONHAM
Practice Address - State:TX
Practice Address - Zip Code:75418-4059
Practice Address - Country:US
Practice Address - Phone:903-583-2111
Practice Address - Fax:903-583-6709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA04429286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital