1013962380 NPI number — WOODLANDS ENDOSCOPY CENTR, LTD.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013962380 NPI number — WOODLANDS ENDOSCOPY CENTR, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WOODLANDS ENDOSCOPY CENTR, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WOODLANDS ENDOSCOPY CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013962380
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/31/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 VISION PARK BLVD
Provider Second Line Business Mailing Address:
SUITE 160
Provider Business Mailing Address City Name:
SHENANDOAH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77384-3002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
936-321-8910
Provider Business Mailing Address Fax Number:
936-321-8913

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
111 VISION PARK BLVD
Provider Second Line Business Practice Location Address:
SUITE 160
Provider Business Practice Location Address City Name:
SHENANDOAH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77384-3002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
936-321-8910
Provider Business Practice Location Address Fax Number:
936-321-8913
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HOLDEN
Authorized Official First Name:
CHRISTOPHER
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CHIEF MANAGER OF LLC
Authorized Official Telephone Number:
615-665-1283

Provider Taxonomy Codes

  • Taxonomy code: 261QE0800X , with the licence number:  008224 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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