Basic Information
| Provider Information | |||||||||
| NPI: | 1518339126 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | WALD | ||||||||
| FirstName: | ORI | ||||||||
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| NamePrefix: | DR. | ||||||||
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| Credential: | M.D PH.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6607 KELVIN DR | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770301925 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8325706456 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6620 MAIN ST STE 1325 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770302332 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7137986376 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2015 | ||||||||
| LastUpdateDate: | 10/22/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208G00000X | 81968 | ZZ | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.