Healthcare Provider Details

I. General information

NPI: 1568846269
Provider Name (Legal Business Name): WOODLANDS SELECT INFUSION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2015
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 VISION PARK BLVD STE 102
SHENANDOAH TX
77384-3008
US

IV. Provider business mailing address

PO BOX 132287
SPRING TX
77393-2287
US

V. Phone/Fax

Practice location:
  • Phone: 281-305-0983
  • Fax: 888-883-9901
Mailing address:
  • Phone: 832-812-8280
  • Fax: 800-500-2344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEVE ROPHAIL
Title or Position: MANAGING MEMBER
Credential:
Phone: 713-679-4487