MEDICARE: WOODLANDS SPECIALTY GROUP PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	1223E0200X	Endodontics	TX
2	1223P0300X	Periodontics	TX
3	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	TX

General Provider Information

NPI Number	:	1750494738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOODLANDS SPECIALTY GROUP PLLC

Provider Business Mailing Address
First Line	:	26615 OAK RIDGE DR
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-1968
Country	:	US
Telephone Number	:	281-296-8600
Fax Number	:	281-296-9509

Provider Business Practice Location Address
First Line	:	25300 BOROUGH PARK DR
Second Line	:	SUITE A
City	:	SPRING
State	:	TX
Zip	:	77380-3552
Country	:	US
Telephone Number	:	281-296-0007
Fax Number	:	281-296-0118

Authorized Official
Title or Position	:	DIR HR/PROFESSIONAL RELATIONS
Name	:	MARY BONEY
Credential	:
Telephone Number	:	281-296-8600

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	09/11/2025

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Directions to “WOODLANDS SPECIALTY GROUP PLLC ” Practice Location

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