Provider Demographics
NPI:1023091097
Name:THE WOODLANDS HEALTHCARE CENTER, LP
Entity type:Organization
Organization Name:THE WOODLANDS HEALTHCARE CENTER, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PPS COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:JEANS
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:281-363-3535
Mailing Address - Street 1:4650 S PANTHER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-2764
Mailing Address - Country:US
Mailing Address - Phone:281-363-3535
Mailing Address - Fax:281-363-3576
Practice Address - Street 1:4650 S PANTHER CREEK DR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-2764
Practice Address - Country:US
Practice Address - Phone:281-363-3535
Practice Address - Fax:281-363-3576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111990313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
455876Medicare ID - Type Unspecified