Provider Demographics
NPI:1972855344
Name:WOODLANDS INTERNAL MEDICINE, P.A.
Entity Type:Organization
Organization Name:WOODLANDS INTERNAL MEDICINE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SESHASREE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARUPUDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:936-271-5400
Mailing Address - Street 1:58 S FAIR MANOR CIR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1086
Mailing Address - Country:US
Mailing Address - Phone:936-271-5400
Mailing Address - Fax:936-271-5402
Practice Address - Street 1:17198 ST LUKES WAY
Practice Address - Street 2:STE 450
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8011
Practice Address - Country:US
Practice Address - Phone:936-271-5400
Practice Address - Fax:936-271-5402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7405207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty