Healthcare Provider Details
I. General information
NPI: 1467989871
Provider Name (Legal Business Name): WOODLAND'S EMERGENCY PHYSICIANS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/16/2017
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17201 I 45 S
SHENANDOAH TX
77385-3311
US
IV. Provider business mailing address
5121 MARYLAND WAY STE 300
BRENTWOOD TN
37027-7516
US
V. Phone/Fax
- Phone: 713-790-3333
- Fax:
- Phone: 855-246-8607
- Fax: 629-216-0568
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
GRIMES
Title or Position: CFO
Credential:
Phone: 855-246-8607