Provider Demographics
NPI:1790295103
Name:WOMEN'S HEALTH ASSOCIATES OF CLEBURNE PLLC
Entity Type:Organization
Organization Name:WOMEN'S HEALTH ASSOCIATES OF CLEBURNE PLLC
Other - Org Name:MERIDIAN OBSTETRICS AND GYNECOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LANDON
Authorized Official - Middle Name:BERNHARDT
Authorized Official - Last Name:LORENZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-984-9057
Mailing Address - Street 1:201 WALLS DR
Mailing Address - Street 2:
Mailing Address - City:CLEBURNE
Mailing Address - State:TX
Mailing Address - Zip Code:76033-4007
Mailing Address - Country:US
Mailing Address - Phone:817-984-9057
Mailing Address - Fax:817-697-4220
Practice Address - Street 1:201 WALLS DR
Practice Address - Street 2:
Practice Address - City:CLEBURNE
Practice Address - State:TX
Practice Address - Zip Code:76033-4007
Practice Address - Country:US
Practice Address - Phone:817-984-9057
Practice Address - Fax:817-697-4220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR3555207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty