Provider Demographics
NPI:1376569756
Name:WOMEN OF THE WOODLANDS OBSTETRICS AND GYNECOLOGY PA
Entity Type:Organization
Organization Name:WOMEN OF THE WOODLANDS OBSTETRICS AND GYNECOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-292-5774
Mailing Address - Street 1:9200 PINECROFT DR
Mailing Address - Street 2:STE. 400
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3279
Mailing Address - Country:US
Mailing Address - Phone:281-292-5774
Mailing Address - Fax:281-292-5780
Practice Address - Street 1:9200 PINECROFT DR
Practice Address - Street 2:STE. 400
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3279
Practice Address - Country:US
Practice Address - Phone:281-292-5774
Practice Address - Fax:281-292-5780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0052MGOtherBCBS
TX171462802Medicaid
TX0052MGOtherBCBS