MEDICARE: AMY L. WOODRUFF M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	K0573	TX

General Provider Information

NPI Number	:	1396768339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY L. WOODRUFF M.D.

Provider Business Mailing Address
First Line	:	6624 FANNIN ST STE 1920
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2330
Country	:	US
Telephone Number	:	713-795-5014
Fax Number	:	713-795-4681

Provider Business Practice Location Address
First Line	:	6624 FANNIN ST STE 1920
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2330
Country	:	US
Telephone Number	:	713-795-5014
Fax Number	:	713-795-4681

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	12/09/2022

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