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General NPI Number Information
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NPI Number | 1396261517
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Entity Type | Organization
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Legal Business Name | THE WOODLANDS ACUTE CARE SURGERY, PLLC
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Dates
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Enumeration Date | 08/18/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9200 PINECROFT DR STE 250
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City | SHENANDOAH
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State | TX
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Zip | 77380-3286
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Country | US
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Telephone | 281-419-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 9200 PINECROFT DR STE 250
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City | SHENANDOAH
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State | TX
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Zip | 77380-3286
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Country | US
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Telephone | 281-419-8400
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JASON MATTHEW BALETTE
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Credential | MD
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Telephone | 281-419-8400
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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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