Active NPI
Vicki Lynn Waters, PA
- Physician Assistant
- Houston, TX
National Provider Identifier
1700366176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA02149
- Practice address
- One Baylor Plaza, Ms: Bcm115
Debakey BLDG., Room M108
Houston, TX 77030 - Phone
- (713) 798-8556
- Fax
- (713) 798-6128
- NPI assigned
- Aug 15, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA02149 | TX | Primary |
Addresses
Primary practice location
One Baylor Plaza, Ms: Bcm115
Debakey BLDG., Room M108
Houston, TX 77030
Mailing address
One Baylor Plaza, Ms: Bcm115
Debakey BLDG., Room M108
Houston, TX 77030
Phone (713) 798-8556
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA02149 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1700366176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ONE BAYLOR PLAZA, MS: BCM115",
"address_2": "DEBAKEY BLDG., ROOM M108",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77030",
"telephone_number": "713-798-8556",
"fax_number": "713-798-6128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ONE BAYLOR PLAZA, MS: BCM115",
"address_2": "DEBAKEY BLDG., ROOM M108",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77030",
"telephone_number": "713-798-8556",
"fax_number": "713-798-6128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERS",
"first_name": "VICKI",
"middle_name": "LYNN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-15",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA02149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.