Provider Demographics
NPI:1972778751
Name:WOMEN SPECIALISTS OF BAYSHORE PLLC
Entity Type:Organization
Organization Name:WOMEN SPECIALISTS OF BAYSHORE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-852-1500
Mailing Address - Street 1:1430 PASADENA BLVD
Mailing Address - Street 2:STE D
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77502-2433
Mailing Address - Country:US
Mailing Address - Phone:713-472-3250
Mailing Address - Fax:713-472-3252
Practice Address - Street 1:1430 PASADENA BLVD
Practice Address - Street 2:STE D
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77502-2433
Practice Address - Country:US
Practice Address - Phone:713-472-3250
Practice Address - Fax:713-472-3252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197433901Medicaid
TX00Z437Medicare PIN