Healthcare Provider Details

I. General information

NPI: 1649116377
Provider Name (Legal Business Name): CHELA C WOODS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E MARSHALL AVE # 400
LONGVIEW TX
75601-5580
US

IV. Provider business mailing address

10129 S WINSTON AVE
CHICAGO IL
60643-1356
US

V. Phone/Fax

Practice location:
  • Phone: 903-315-2000
  • Fax:
Mailing address:
  • Phone: 773-668-4544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: