Provider Demographics
NPI:1093252256
Name:THE WOODLANDS COLON AND RECTAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:THE WOODLANDS COLON AND RECTAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NSIKAK
Authorized Official - Middle Name:JARLATH
Authorized Official - Last Name:UMOH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-663-0037
Mailing Address - Street 1:920 MEDICAL PLAZA DR STE 330
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3271
Mailing Address - Country:US
Mailing Address - Phone:832-663-0037
Mailing Address - Fax:281-962-3033
Practice Address - Street 1:920 MEDICAL PLAZA DR STE 330
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3271
Practice Address - Country:US
Practice Address - Phone:832-663-0037
Practice Address - Fax:281-962-3033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-26
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ5591208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty