Provider Demographics
NPI:1508184862
Name:NORTHWOODS ANESTHESIA, P.A.
Entity Type:Organization
Organization Name:NORTHWOODS ANESTHESIA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-523-0300
Mailing Address - Street 1:13114 FM 1960 W
Mailing Address - Street 2:SUITE 118 A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-4290
Mailing Address - Country:US
Mailing Address - Phone:713-559-9100
Mailing Address - Fax:
Practice Address - Street 1:13114 FM 1960 W
Practice Address - Street 2:SUITE 118 A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4290
Practice Address - Country:US
Practice Address - Phone:713-559-9100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7319207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX151661901Medicaid
TX00480TMedicare PIN
TXH41611Medicare UPIN