Provider Demographics
NPI:1285812883
Name:WOMEN SPECIALISTS OF KATY, P.A.
Entity type:Organization
Organization Name:WOMEN SPECIALISTS OF KATY, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:COROVESSIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-398-2140
Mailing Address - Street 1:21700 KINGSLAND BLVD
Mailing Address - Street 2:SUITE #203
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-2545
Mailing Address - Country:US
Mailing Address - Phone:281-398-2140
Mailing Address - Fax:281-398-0017
Practice Address - Street 1:21700 KINGSLAND BLVD
Practice Address - Street 2:SUITE #203
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-2545
Practice Address - Country:US
Practice Address - Phone:281-398-2140
Practice Address - Fax:281-398-0017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-06
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4894174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174248801Medicaid
TXH7155Medicare UPIN
TX174248801Medicaid