Organization Active NPI

Obstetrics and Gynecology of the Woodlands, P.a.

  • Obstetrics & Gynecology Physician
  • The Woodlands, TX
National Provider Identifier
1679597256
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
J8848 Issued in TX
Legal business name
OBSTETRICS AND GYNECOLOGY OF THE WOODLANDS, P.A.
Practice address
17350 St Lukes Way
Suite 300
The Woodlands, TX 77384-4100
Phone
(281) 419-5010
Fax
(936) 273-4418
NPI assigned
Jul 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

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

Authorized official

Name
Jerome Clayton Young, M.D.
Title
Chief Executive Officer
Phone
(281) 419-5010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X J8848 TX Primary

Addresses

Primary practice location

17350 St Lukes Way
Suite 300
The Woodlands, TX 77384-4100

Mailing address

17350 St Lukes Way
Suite 300
The Woodlands, TX 77384-4100
Phone (281) 419-5010

Other identifiers 2

IdentifierTypeStateIssuer
0085EVOtherTXBLUE CROSS/BLUE SHIELD
176932501MedicaidTX

National Provider Directory

National Provider Directory

Locations

17350 St Lukes Way
Ste 300
The Woodlands, TX 77384
Phone (281) 419-5010

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": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259539200000",
    "number": "1679597256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17350 ST LUKES WAY",
            "address_2": "SUITE 300",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844100",
            "telephone_number": "281-419-5010",
            "fax_number": "936-273-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17350 ST LUKES WAY",
            "address_2": "SUITE 300",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773844100",
            "telephone_number": "281-419-5010",
            "fax_number": "936-273-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSTETRICS AND GYNECOLOGY OF THE WOODLANDS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2009-11-30",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "CLAYTON",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "281-419-5010",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "J8848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "0085EV",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176932501",
            "state": "TX"
        }
    ],
    "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 Nov 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.