Organization Active NPI

Borealis Women'S Services, PLLC

  • Obstetrics & Gynecology Physician
  • The Woodlands, TX
National Provider Identifier
1255148128
Registry record updated Dec 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
BOREALIS WOMEN'S SERVICES, PLLC
Practice address
200 Valley Wood Dr Ste A200
The Woodlands, TX 77380-3673
Phone
(832) 446-0301
Fax
(832) 446-0302
NPI assigned
Dec 14, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Borel Fonhoue, MDNPI 1780173468
Title
Physician Owner
Phone
(801) 719-4224

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

200 Valley Wood Dr Ste A200
The Woodlands, TX 77380-3673

Mailing address

3120 Southwest Fwy
Ste 101 PMB 279433
Houston, TX 77098
Phone (831) 446-0301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250107002928 TX Part B Supplier - Clinic/Group Practice 7911435714 Receives reassigned benefits from 1 practitioner
Practice locations: The Woodlands, TX

National Provider Directory

National Provider Directory

Locations

200 Valley Wood Dr
Ste A200
The Woodlands, TX 77380
Phone (832) 446-0301

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734134400000",
    "number": "1255148128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 SOUTHWEST FWY",
            "address_2": "STE 101 PMB 279433",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77098",
            "telephone_number": "831-446-0301",
            "fax_number": "832-446-0302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VALLEY WOOD DR STE A200",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773803673",
            "telephone_number": "832-446-0301",
            "fax_number": "832-446-0302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOREALIS WOMEN'S SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-14",
        "last_updated": "2024-12-14",
        "certification_date": "2024-12-14",
        "status": "A",
        "authorized_official_last_name": "FONHOUE",
        "authorized_official_first_name": "BOREL",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "801-719-4224",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.