Provider Demographics
NPI:1437860657
Name:COPPER AND GREENS
Entity Type:Organization
Organization Name:COPPER AND GREENS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH STRATEGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:GWENDOLYN
Authorized Official - Middle Name:SHERRON
Authorized Official - Last Name:WOODY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, CCM, CN, CDP
Authorized Official - Phone:281-249-9444
Mailing Address - Street 1:8990 KIRBY DR STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2853
Mailing Address - Country:US
Mailing Address - Phone:281-249-9444
Mailing Address - Fax:
Practice Address - Street 1:3422 BUSINESS CENTER DR STE 106
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4159
Practice Address - Country:US
Practice Address - Phone:281-249-9444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2023-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or WelfareGroup - Multi-Specialty
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity HealthGroup - Multi-Specialty
No261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX119001OtherOTHER NON MEDICARE IDENTIFIER