Provider Demographics
NPI:1003977190
Name:NORTHWEST WOMENS CLINIC P A
Entity Type:Organization
Organization Name:NORTHWEST WOMENS CLINIC P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M D
Authorized Official - Prefix:
Authorized Official - First Name:IRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:512-338-5161
Mailing Address - Street 1:11673 JOLLYVILLE RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-3933
Mailing Address - Country:US
Mailing Address - Phone:512-338-5161
Mailing Address - Fax:512-338-5019
Practice Address - Street 1:11673 JOLLYVILLE RD
Practice Address - Street 2:SUITE 205
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3933
Practice Address - Country:US
Practice Address - Phone:512-338-5161
Practice Address - Fax:512-338-5019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G952Medicare ID - Type Unspecified