Provider Demographics
NPI:1811076417
Name:WOODBURY, JULIE (CPNP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:WOODBURY
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 WIRT RD STE F8
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-1232
Mailing Address - Country:US
Mailing Address - Phone:713-467-4900
Mailing Address - Fax:137-467-6006
Practice Address - Street 1:2323 WIRT RD STE F8
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-1232
Practice Address - Country:US
Practice Address - Phone:713-467-4900
Practice Address - Fax:713-467-6006
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX663926363LP0200X
TXAP115181363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7069OtherPRESCRIPTION AUTHORITY
TX32943802Medicaid
TX663926OtherRN
TX32943801Medicaid
TXAP115181OtherAPRN