Organization
OBSTETRICS AND GYNECOLOGY OF THE WOODLANDS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME CLAYTON YOUNG M.D. (CHIEF EXECUTIVE OFFICER)
(281) 419-5010
Entity
Organization
Contact information
Practice address
17350 ST LUKES WAY, SUITE 300, THE WOODLANDS, TX 77384-4100
(281) 419-5010
(936) 273-4418
Mailing address
17350 ST LUKES WAY, SUITE 300, THE WOODLANDS, TX 77384-4100
(281) 419-5010
(936) 273-4418
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
J8848
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0085EV
BLUE CROSS/BLUE SHIELD
TX
05
—
176932501
—
TX
Enumeration date
07/27/2006
Last updated
11/30/2009
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