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General NPI Number Information
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NPI Number | 1225419716
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Entity Type | Organization
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Legal Business Name | WOODLANDS WAY MEDICAL CENTER
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Dates
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Enumeration Date | 06/10/2015
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Last Update Date | 12/09/2016
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Provider Practice Location Address
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Address Line | 17350 ST LUKES WAY 370
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City | THE WOODLANDS
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State | TX
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Zip | 77384-4100
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Country | US
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Telephone | 331-305-2813
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 JORIE BLVD 370
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City | BURR RIDGE
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State | IL
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Zip | 60527-5777
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Country | US
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Telephone | 331-305-2813
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MARLA GUICE
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Credential |
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Telephone | 331-305-2813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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