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General NPI Number Information
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NPI Number | 1730429614
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Entity Type | Organization
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Legal Business Name | NORTHWEST INJURY & WELLNESS CENTER
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Dates
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Enumeration Date | 02/28/2013
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Last Update Date | 02/28/2013
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Provider Practice Location Address
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Address Line | 2000 NORTH LOOP W SUITE 200
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City | HOUSTON
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State | TX
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Zip | 77018-8124
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Country | US
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Telephone | 281-501-9461
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Fax | 713-677-0807
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Provider Business Mailing Address
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Address Line | 2000 NORTH LOOP W SUITE 200
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City | HOUSTON
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State | TX
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Zip | 77018-8124
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Country | US
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Telephone | 281-501-9461
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Fax | 713-677-0807
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | MS. TRACIE WOODS
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Credential |
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Telephone | 281-501-9461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | F0010332
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License Number State | TX
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