Provider Demographics
NPI:1851672455
Name:VANESSA WOOLRIDGE MD, P.A.
Entity Type:Organization
Organization Name:VANESSA WOOLRIDGE MD, P.A.
Other - Org Name:VANESSA WOOLRIDGE MD, P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:L
Authorized Official - Last Name:BECKNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-964-5514
Mailing Address - Street 1:1600 COIT RD STE 208C
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6172
Mailing Address - Country:US
Mailing Address - Phone:972-964-5514
Mailing Address - Fax:972-312-1476
Practice Address - Street 1:1600 COIT RD STE 208C
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6172
Practice Address - Country:US
Practice Address - Phone:972-964-5514
Practice Address - Fax:972-312-1476
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VANESSA WOOLRIDGE MD, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ9448207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty