Provider Demographics
NPI:1578769956
Name:PLANO WOMENS HEALTHCARE
Entity Type:Organization
Organization Name:PLANO WOMENS HEALTHCARE
Other - Org Name:JACOBS & UMHOLTZ, PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:UMHOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-596-2470
Mailing Address - Street 1:1600 COIT RD
Mailing Address - Street 2:#202
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6174
Mailing Address - Country:US
Mailing Address - Phone:972-596-2470
Mailing Address - Fax:972-985-9892
Practice Address - Street 1:1600 COIT RD
Practice Address - Street 2:#202
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6174
Practice Address - Country:US
Practice Address - Phone:972-596-2470
Practice Address - Fax:972-985-9892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE09339Medicare UPIN
TXE08976Medicare UPIN
TXG57437Medicare UPIN
TXG03786Medicare UPIN
TX00B98SMedicare ID - Type Unspecified