Healthcare Provider Details

I. General information

NPI: 1790595213
Provider Name (Legal Business Name): WOODFOREST RESTORATION AND WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 SUGAR PINE CT
MONTGOMERY TX
77316-2472
US

IV. Provider business mailing address

126 SUGAR PINE CT
MONTGOMERY TX
77316-2472
US

V. Phone/Fax

Practice location:
  • Phone: 318-792-3864
  • Fax:
Mailing address:
  • Phone: 318-792-3864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LINDSAY ROSS
Title or Position: OWNER AND NURSE PRACTITIONER
Credential: FNP-C
Phone: 318-792-3864