Provider Demographics
NPI:1962852269
Name:AC WOMEN'S HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:AC WOMEN'S HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:WOMEN'S HEALTH NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:409-256-1901
Mailing Address - Street 1:22031 THORNGROVE LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-4837
Mailing Address - Country:US
Mailing Address - Phone:409-256-1901
Mailing Address - Fax:
Practice Address - Street 1:22031 THORNGROVE LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77389-4837
Practice Address - Country:US
Practice Address - Phone:409-256-1901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-16
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP121816363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
13820684OtherCAQH
TX1457742389OtherINDIVIDUAL NPI
TXAP121816OtherAPRN LICENSE NUMBER
TX501730ZU0BOtherMEDICARE ID