Provider Demographics
NPI:1942308457
Name:WOMEN'S PROFESSIONAL HEALTH CENTER
Entity Type:Organization
Organization Name:WOMEN'S PROFESSIONAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NOSHI
Authorized Official - Middle Name:B
Authorized Official - Last Name:GHATTAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-693-4461
Mailing Address - Street 1:1605 ROCK PRAIRIE RD
Mailing Address - Street 2:220
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845
Mailing Address - Country:US
Mailing Address - Phone:979-693-4461
Mailing Address - Fax:979-696-1358
Practice Address - Street 1:1605 ROCK PRAIRIE RD
Practice Address - Street 2:220
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845
Practice Address - Country:US
Practice Address - Phone:979-693-4461
Practice Address - Fax:979-696-1358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00K39QMedicare ID - Type Unspecified