Provider Demographics
NPI:1699838938
Name:PHYSICIANS GROUP OF THE WOODLANDS
Entity Type:Organization
Organization Name:PHYSICIANS GROUP OF THE WOODLANDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THIMOS
Authorized Official - Middle Name:G
Authorized Official - Last Name:PASCHALIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-296-8500
Mailing Address - Street 1:134 VISION PARK BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3032
Mailing Address - Country:US
Mailing Address - Phone:281-296-8500
Mailing Address - Fax:281-296-8591
Practice Address - Street 1:134 VISION PARK BLVD STE 300
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3032
Practice Address - Country:US
Practice Address - Phone:281-296-8500
Practice Address - Fax:281-296-8591
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRIVIA MEDICAL GROUP GULF COAST, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-18
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00908NMedicare ID - Type Unspecified