Provider Demographics
NPI:1922850486
Name:WOODS, JEKEL MAGDALENE
Entity Type:Individual
Prefix:
First Name:JEKEL
Middle Name:MAGDALENE
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 WINNIPEG AVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-2344
Mailing Address - Country:US
Mailing Address - Phone:337-501-8540
Mailing Address - Fax:
Practice Address - Street 1:3100 CLEBURNE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-4501
Practice Address - Country:US
Practice Address - Phone:337-501-8540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program