Provider Demographics
NPI:1629080007
Name:BIRTH AND WOMENS CENTER
Entity Type:Organization
Organization Name:BIRTH AND WOMENS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CERTIFIED NURSE-MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:CHERIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOETTCHER
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:214-821-8190
Mailing Address - Street 1:3100 SWISS AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-6025
Mailing Address - Country:US
Mailing Address - Phone:214-821-8190
Mailing Address - Fax:214-821-9040
Practice Address - Street 1:3100 SWISS AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6025
Practice Address - Country:US
Practice Address - Phone:214-821-8190
Practice Address - Fax:214-821-9040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-48188176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH1606OtherBCBS PROVIDER ID - BWC
TX4451337OtherAETNA PROVIDER # - CNM
TX4581569OtherAETNA PROVIDER ID - BWC
TX86N553OtherBCBS ID # - CNM