Healthcare Provider Details
I. General information
NPI: 1609268960
Provider Name (Legal Business Name): THE CENTER FOR WOMENS SEXUAL HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/24/2015
Last Update Date: 09/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1315 ST JOSEPH PKWY SUITE 1306
HOUSTON TX
77002-8233
US
IV. Provider business mailing address
4827 BELLAIRE BLVD
BELLAIRE TX
77401-4421
US
V. Phone/Fax
- Phone: 832-924-8788
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VF0040X |
| Taxonomy | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician |
| License Number | K7034 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2088F0040X |
| Taxonomy | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician |
| License Number | K7034 |
| License Number State | TX |
VIII. Authorized Official
Name:
CHRIS
JAYNE
Title or Position: OWNER
Credential: MD
Phone: 832-924-8788