TOMBALL CBOC (3655) INSTITUTION (4)

Name	Value
NAME	TOMBALL CBOC
STATE	TEXAS
STREET ADDR. 1	1200 W. MAIN
CITY	TOMBALL
ZIP	77375-5522
OFFICIAL VA NAME	TOMBALL CBOC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 16 PARENT FACILITY PARENT OF ASSOCIATION: HOUSTON VAMC
BILLING FACILITY NAME	TOMBALL VA CBOC
EFFECTIVE DATE/TIME	2013-06-28 00:00:00 STATUS: ACTIVE NPI: 1790117398
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	CENTRAL
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	580GH
IDENTIFIER	CODING SYSTEM: CLIA ID: 45D2064744