Provider Demographics
NPI:1861712879
Name:WOODLANDS INPATIENT PHYSICIANS PA
Entity type:Organization
Organization Name:WOODLANDS INPATIENT PHYSICIANS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ASI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-587-5078
Mailing Address - Street 1:PO BOX 4346
Mailing Address - Street 2:DEPARTMENT 94
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4346
Mailing Address - Country:US
Mailing Address - Phone:281-587-5078
Mailing Address - Fax:281-465-4596
Practice Address - Street 1:1111 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 250
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3240
Practice Address - Country:US
Practice Address - Phone:281-587-5078
Practice Address - Fax:281-465-4596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX214450301Medicaid
TX214450301Medicaid