Basic Information
| Provider Information | |||||||||
| NPI: | 1184042822 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WOODLANDS SPECIALTY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25440 INTERSTATE 45 N | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | THE WOODLANDS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773861343 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2816028160 | ||||||||
| FaxNumber: | 2814661052 | ||||||||
| Practice Location | |||||||||
| Address1: | 25440 INTERSTATE 45 N | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | THE WOODLANDS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773861343 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2816028160 | ||||||||
| FaxNumber: | 2814661052 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/31/2014 | ||||||||
| LastUpdateDate: | 08/12/2014 | ||||||||
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| AuthorizedOfficialLastName: | MOPARTY | ||||||||
| AuthorizedOfficialFirstName: | RAVI | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER / CEO | ||||||||
| AuthorizedOfficialTelephone: | 8323268032 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 100265 | TX | Y | Hospitals | General Acute Care Hospital |
No ID Information.