Provider Demographics
NPI:1861412314
Name:WOODING, HAZEL L (NP)
Entity type:Individual
Prefix:MRS
First Name:HAZEL
Middle Name:L
Last Name:WOODING
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2209
Mailing Address - Street 2:
Mailing Address - City:ANAHUAC
Mailing Address - State:TX
Mailing Address - Zip Code:77514-2209
Mailing Address - Country:US
Mailing Address - Phone:409-252-3412
Mailing Address - Fax:409-252-3413
Practice Address - Street 1:4600 POST OAK PLACE DR
Practice Address - Street 2:307
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-9705
Practice Address - Country:US
Practice Address - Phone:713-581-8785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX538522363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX286363102Medicaid
TX286363102Medicaid