Provider Demographics
NPI:1558666222
Name:EXCLUSIVELY GYN
Entity Type:Organization
Organization Name:EXCLUSIVELY GYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OB/GYN
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-226-0320
Mailing Address - Street 1:9659 N SAM HOUSTON PKWY E
Mailing Address - Street 2:SUITE 150 #251
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-1529
Mailing Address - Country:US
Mailing Address - Phone:281-226-0320
Mailing Address - Fax:281-454-7691
Practice Address - Street 1:9659 N SAM HOUSTON PKWY E
Practice Address - Street 2:SUITE 150 #251
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-1529
Practice Address - Country:US
Practice Address - Phone:281-226-0320
Practice Address - Fax:281-454-7691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-11
Last Update Date:2011-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7562174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty