MEDICARE: SPECIALISTS IN OBSTETRICS AND GYNECOLOGY, PLLC

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1447407226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIALISTS IN OBSTETRICS AND GYNECOLOGY, PLLC

Provider Business Mailing Address
First Line	:	2000 HEALTH PARK DR
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-4692
Country	:	US
Telephone Number	:	615-373-7406
Fax Number	:

Provider Business Practice Location Address
First Line	:	7400 FANNIN ST STE 840
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1934
Country	:	US
Telephone Number	:	713-799-9091
Fax Number	:

Authorized Official
Title or Position	:	GROUP VICE PRESIDENT
Name	:	NICHOLAS WADLINGTON
Credential	:
Telephone Number	:	615-372-7332

Provider Enumeration Date	:	08/22/2008
Last Update Date	:	11/21/2025

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