Basic Information
| Provider Information | |||||||||
| NPI: | 1992720387 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TORONJO | ||||||||
| FirstName: | WALTER | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 521 I-H 45 S. | ||||||||
| Address2: | STE. 11 | ||||||||
| City: | HUNTSVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9362912700 | ||||||||
| FaxNumber: | 9362912963 | ||||||||
| Practice Location | |||||||||
| Address1: | 521 I-H 45 S. | ||||||||
| Address2: | STE. 11 | ||||||||
| City: | HUNTSVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77340 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9362913411 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2006 | ||||||||
| LastUpdateDate: | 03/16/2010 | ||||||||
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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 | 207P00000X | F2069 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | F2069 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 138797914 | 05 | TX | MEDICAID |