Healthcare Provider Details

I. General information

NPI: 1396261517
Provider Name (Legal Business Name): THE WOODLANDS ACUTE CARE SURGERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 PINECROFT DR STE 250
SHENANDOAH TX
77380-3286
US

IV. Provider business mailing address

9200 PINECROFT DR STE 250
SHENANDOAH TX
77380-3286
US

V. Phone/Fax

Practice location:
  • Phone: 281-419-8400
  • Fax:
Mailing address:
  • Phone: 281-419-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JASON MATTHEW BALETTE
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 281-419-8400