1710932827 NPI number — DR. FLORENCE WOOTEN M.D.

Table of content: DR. FLORENCE WOOTEN M.D. (NPI 1710932827)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710932827 NPI number — DR. FLORENCE WOOTEN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WOOTEN
Provider First Name:
FLORENCE
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1710932827
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 CRAWFORD ST
Provider Second Line Business Mailing Address:
1200
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77002-9000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-652-9898
Provider Business Mailing Address Fax Number:
713-652-9899

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 CRAWFORD ST
Provider Second Line Business Practice Location Address:
1200
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77002-9000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-652-9898
Provider Business Practice Location Address Fax Number:
713-652-9899
Provider Enumeration Date:
05/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  H1060 , 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)

  • Identifier: 113448801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4012560001 . This is a "PALMETTO (DMERC)" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 180034644 . This is a "RAILRAOD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3418774 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00342G . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2285691 . This is a "AETNA US HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4012560001 . This is a "CIGNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1359620 . This is a "HEALTHMARKET" identifier . This identifiers is of the category "OTHER".
  • Identifier: SPECTERA . This is a "23926" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 10014485 . This is a "AMERIGROUP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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