Provider Demographics
NPI:1568475630
Name:THE WOODSTEAD GROUP P.A.
Entity Type:Organization
Organization Name:THE WOODSTEAD GROUP P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:OHILDA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-681-8040
Mailing Address - Street 1:1733 WOODSTEAD CT.
Mailing Address - Street 2:STE #206
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380
Mailing Address - Country:US
Mailing Address - Phone:281-681-8040
Mailing Address - Fax:281-296-0093
Practice Address - Street 1:1733 WOODSTEAD CT.
Practice Address - Street 2:STE #206
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:281-681-8040
Practice Address - Fax:281-296-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0056NXOtherBCBS
TX186118901Medicaid
TX00X141Medicare PIN