Provider Demographics
NPI:1144227034
Name:HEALTHY WOMAN PA
Entity Type:Organization
Organization Name:HEALTHY WOMAN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FELIPE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARCIA-GHINIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-648-2273
Mailing Address - Street 1:2632 BROADWAY ST
Mailing Address - Street 2:SUITE 301N
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215-1137
Mailing Address - Country:US
Mailing Address - Phone:210-648-2273
Mailing Address - Fax:210-648-2228
Practice Address - Street 1:2632 BROADWAY ST
Practice Address - Street 2:SUITE 301N
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-1137
Practice Address - Country:US
Practice Address - Phone:210-648-2273
Practice Address - Fax:210-648-2228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-07
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6389207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170188001Medicaid
TX170188001Medicaid