Provider Demographics
NPI:1982403671
Name:ETHANWOODS LLC
Entity type:Organization
Organization Name:ETHANWOODS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MUHSIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NSUBUGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-962-1821
Mailing Address - Street 1:17350 STATE HIGHWAY 249 STE 220
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1132
Mailing Address - Country:US
Mailing Address - Phone:512-962-1821
Mailing Address - Fax:
Practice Address - Street 1:121 ETHAN RUN
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78628-3725
Practice Address - Country:US
Practice Address - Phone:512-962-1821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)