Provider Demographics
NPI:1629600309
Name:WOODUS OBSTETRICS AND GYNECOLOGY, PLLC
Entity Type:Organization
Organization Name:WOODUS OBSTETRICS AND GYNECOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-206-9080
Mailing Address - Street 1:9101 LBJ FWY STE 710
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1912
Mailing Address - Country:US
Mailing Address - Phone:972-792-5700
Mailing Address - Fax:214-506-1170
Practice Address - Street 1:1121 N JOE WILSON RD
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-1430
Practice Address - Country:US
Practice Address - Phone:469-206-9080
Practice Address - Fax:469-206-9081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty