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NPI Code Detail

MEDICARE: DR. WOODROW WILLIAM COPPEDGE M.D.

MEDICARE: DR. WOODROW WILLIAM COPPEDGE 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
12084P0800XPsychiatry PhysicianL2853TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28G7084OTHERTXBLUE CROSS BLUE SHIELD
310050535OTHERTXAMERIGROUP

General Provider Information

NPI Number : 1952356321
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WOODROW WILLIAM COPPEDGE M.D.
Provider Business Mailing Address
First Line : 9401 SOUTHWEST FWY
Second Line :
City : HOUSTON
State : TX
Zip : 77074-1407
Country : US
Telephone Number : 713-970-7000
Fax Number :
Provider Business Practice Location Address
First Line : 5901 LONG DR
Second Line :
City : HOUSTON
State : TX
Zip : 77087-1003
Country : US
Telephone Number : 713-970-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2006
Last Update Date : 06/12/2019

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