Provider Demographics
NPI:1043229966
Name:WAXAHACHIE WOMENS HEALTH
Entity Type:Organization
Organization Name:WAXAHACHIE WOMENS HEALTH
Other - Org Name:WOMEN'S HEALTH SPECIALISTS OF NORTH TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-938-3493
Mailing Address - Street 1:2460 N IH 35 E STE 165
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-5258
Mailing Address - Country:US
Mailing Address - Phone:972-938-3493
Mailing Address - Fax:972-937-5608
Practice Address - Street 1:2460 N IH 35 E STE 165
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-5258
Practice Address - Country:US
Practice Address - Phone:972-938-3493
Practice Address - Fax:972-937-5608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174781801Medicaid
TX174781801Medicaid