Provider Demographics
NPI:1992224612
Name:WOMEN'S HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:WOMEN'S HEALTH CARE SERVICES
Other - Org Name:WOMEN'S HEALTH CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:REPO-MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-886-3088
Mailing Address - Street 1:PO BOX 3467
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:NM
Mailing Address - Zip Code:88021-3467
Mailing Address - Country:US
Mailing Address - Phone:915-886-3088
Mailing Address - Fax:915-886-3022
Practice Address - Street 1:141 VINTON RD STE E5
Practice Address - Street 2:
Practice Address - City:VINTON
Practice Address - State:TX
Practice Address - Zip Code:79821-8810
Practice Address - Country:US
Practice Address - Phone:915-886-3088
Practice Address - Fax:915-886-3022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP110542363LF0000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty