Provider Demographics
NPI:1568725018
Name:WILLOW BEND OB/GYN, PLLC
Entity Type:Organization
Organization Name:WILLOW BEND OB/GYN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:MURRAY
Authorized Official - Last Name:FERRARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-468-8158
Mailing Address - Street 1:3004 COMMUNICATIONS PARKWAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8904
Mailing Address - Country:US
Mailing Address - Phone:972-468-8158
Mailing Address - Fax:972-473-4808
Practice Address - Street 1:3004 COMMUNICATIONS PARKWAY
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8904
Practice Address - Country:US
Practice Address - Phone:972-468-8158
Practice Address - Fax:972-473-4808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6582207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty