Provider Demographics
NPI:1578555488
Name:THE WOMENS HEALTH CLINIC, INC.
Entity Type:Organization
Organization Name:THE WOMENS HEALTH CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-428-1793
Mailing Address - Street 1:4201 GARTH RD
Mailing Address - Street 2:# 303
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3156
Mailing Address - Country:US
Mailing Address - Phone:281-428-1793
Mailing Address - Fax:281-420-9604
Practice Address - Street 1:4201 GARTH RD
Practice Address - Street 2:# 303
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3156
Practice Address - Country:US
Practice Address - Phone:281-428-1793
Practice Address - Fax:281-420-9604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096543602Medicaid
TX160046845OtherMEDICARE RAILROAD
TX00827XMedicare PIN
TXF92755Medicare UPIN