Provider Demographics
NPI:1295952216
Name:ADVANTAGE WOMEN'S CARE PA
Entity type:Organization
Organization Name:ADVANTAGE WOMEN'S CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:T
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-537-5556
Mailing Address - Street 1:19740 INTERSTATE 45 N
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-2941
Mailing Address - Country:US
Mailing Address - Phone:281-537-5556
Mailing Address - Fax:281-537-5560
Practice Address - Street 1:19740 INTERSTATE 45 N
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-2941
Practice Address - Country:US
Practice Address - Phone:281-537-5556
Practice Address - Fax:281-537-5560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM1975207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181597901Medicaid
TX00X482Medicare PIN
TX8F4850Medicare UPIN