Provider Demographics
NPI:1124219225
Name:AMY L. WOODRUFF, M.D., P.A.
Entity Type:Organization
Organization Name:AMY L. WOODRUFF, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOODRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-795-5014
Mailing Address - Street 1:6624 FANNIN ST STE 1920
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2330
Mailing Address - Country:US
Mailing Address - Phone:713-795-5014
Mailing Address - Fax:713-795-4681
Practice Address - Street 1:6624 FANNIN ST STE 1920
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2330
Practice Address - Country:US
Practice Address - Phone:713-795-5014
Practice Address - Fax:713-795-4681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG76533Medicare UPIN