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General NPI Number Information
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NPI Number | 1003418229
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Entity Type | Organization
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Legal Business Name | WILLOW WOMEN'S HEALTH, PLLC
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Dates
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Enumeration Date | 11/12/2020
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Last Update Date | 03/02/2021
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Provider Practice Location Address
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Address Line | 712 N WASHINGTON AVE STE 250
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City | DALLAS
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State | TX
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Zip | 75246-1631
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Country | US
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Telephone | 806-470-7918
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Fax |
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Provider Business Mailing Address
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Address Line | 2840 LEGACY DR STE 400
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City | FRISCO
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State | TX
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Zip | 75034-6055
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Country | US
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Telephone | 469-476-5623
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. SHRUTI BENJAMIN
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Credential | MD
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Telephone | 806-470-7918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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