Provider Demographics
NPI:1942607627
Name:WOMEN'S SPECIALISTS OF SUGAR LAND, PLLC
Entity Type:Organization
Organization Name:WOMEN'S SPECIALISTS OF SUGAR LAND, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-512-7083
Mailing Address - Street 1:PO BOX 3140
Mailing Address - Street 2:DEPARTMENT 900
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77253-3140
Mailing Address - Country:US
Mailing Address - Phone:713-578-3833
Mailing Address - Fax:281-201-2345
Practice Address - Street 1:16659 SOUTHWEST FWY
Practice Address - Street 2:SUITE 225 BUILDING 2
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2375
Practice Address - Country:US
Practice Address - Phone:713-578-3833
Practice Address - Fax:281-201-2345
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHWEST WOMEN'S HEALTH ALLIANCE, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-11-25
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty