Provider Demographics
NPI:1174780308
Name:WOODWAY REHAB & WELLNESS CENTER PA
Entity type:Organization
Organization Name:WOODWAY REHAB & WELLNESS CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RONA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENLAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-622-2225
Mailing Address - Street 1:4801 WOODWAY DR
Mailing Address - Street 2:SUITE 175-E
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-1813
Mailing Address - Country:US
Mailing Address - Phone:713-622-2225
Mailing Address - Fax:
Practice Address - Street 1:4801 WOODWAY DR
Practice Address - Street 2:SUITE 175-E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-1813
Practice Address - Country:US
Practice Address - Phone:713-622-2225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2751111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical ExaminerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0095JHOtherBLUE CROSS BLUE SHEILD