Provider Demographics
NPI:1740624352
Name:WOMAN'S CLINIC PLLC
Entity type:Organization
Organization Name:WOMAN'S CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHESH
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHETTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-899-3797
Mailing Address - Street 1:2424 W HOLCOMBE BLVD STE 102
Mailing Address - Street 2:DEPARTMENT 628
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1933
Mailing Address - Country:US
Mailing Address - Phone:832-804-8119
Mailing Address - Fax:832-804-8120
Practice Address - Street 1:6051 GARTH RD
Practice Address - Street 2:STE 200
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-9890
Practice Address - Country:US
Practice Address - Phone:281-837-5266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOMAN'S CLINIC PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-25
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty