Provider Demographics
NPI:1912282047
Name:WOODLANDS VEIN AND LASER CENTER
Entity Type:Organization
Organization Name:WOODLANDS VEIN AND LASER CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:HARVEY
Authorized Official - Last Name:BRINTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-885-9207
Mailing Address - Street 1:9191 PINECROFT DR
Mailing Address - Street 2:SUITE 245
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-2796
Mailing Address - Country:US
Mailing Address - Phone:281-886-7167
Mailing Address - Fax:281-419-3377
Practice Address - Street 1:9191 PINECROFT DR
Practice Address - Street 2:SUITE 245
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-2796
Practice Address - Country:US
Practice Address - Phone:281-885-9207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9680261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty