# PORTERCARE ADVENTIST HEALTH SYSTEM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CMG Primary Care Woodlands, PRWL PC WOODLANDS, Centura Medical Group Primary Care Woodlands, AdventHealth Medical Group Family Medicine at Woodlands
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730704479
- **Authorized official:** MR. JASON TACHA (COO)
- **Authorized official phone:** (303) 304-7752

## Contact information

- **Practice address:** 4344 WOODLANDS BLVD STE 260, CASTLE ROCK, CO 80104-2801
- **Practice address phone:** (303) 649-3155
- **Practice address fax:** (303) 649-3156
- **Mailing address:** PO BOX 713425, CHICAGO, IL 60677-4325
- **Mailing address phone:** (800) 953-0104
- **Mailing address fax:** (303) 765-6670

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 06/09/2020
- **Last updated:** 08/12/2026