Organization Active NPI

Woodlands Vein Center & Preventative Medicine Clinic

  • Clinic/Center
  • Shenandoah, TX
National Provider Identifier
1790366714
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
WOODLANDS VEIN CENTER & PREVENTATIVE MEDICINE CLINIC
Practice address
150 Pine Forest Dr Ste 703
Shenandoah, TX 77384-5317
Phone
(281) 939-5915
NPI assigned
Apr 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Authorized official

Name
Dr. Arindam Mohon Banerjee, MDNPI 1861402810
Title
Owner/Medical Director
Phone
(281) 795-3386

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Multi-Specialty Clinic/Center 261QM1300X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

150 Pine Forest Dr Ste 703
Shenandoah, TX 77384-5317

Mailing address

150 Pine Forest Dr Ste 703
Shenandoah, TX 77384-5317
Phone (281) 795-3386

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210812000066 TX Part B Supplier - Clinic/Group Practice 4183028293 Receives reassigned benefits from 2 practitioners
Practice locations: Conroe, TX

National Provider Directory

National Provider Directory

Locations

150 Pine Forest Dr
Ste 703
The Woodlands, TX 77384
Phone (281) 939-5915

Practitioners & affiliated clinicians

Practitioners 2

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": "1618876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1790366714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 PINE FOREST DR STE 703",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773845317",
            "telephone_number": "281-795-3386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 PINE FOREST DR STE 703",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773845317",
            "telephone_number": "281-939-5915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLANDS VEIN CENTER & PREVENTATIVE MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-20",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "BANERJEE",
        "authorized_official_first_name": "ARINDAM",
        "authorized_official_middle_name": "MOHON",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "281-795-3386",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.