Individual provider Active NPI

Christy A Woodruff, MD

  • Dermatology Physician
  • Brenham, TX
National Provider Identifier
1821099953
Registry record updated Sep 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
L2758 Issued in TX
Practice address
68Oo Quebe Rd
Brenham, TX 77833
Phone
(713) 303-0037
NPI assigned
Aug 10, 2005
Reactivated
Mar 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X L2758 TX
Dermatology Physician 207N00000X L2758 TX Primary

Addresses

Primary practice location

68Oo Quebe Rd
Brenham, TX 77833

Mailing address

PO Box 7
Brenham, TX 77834-0007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040609001275 TX Practitioner - Dermatology 6002899242 Reassigns benefits to 1 organization
I20240605004220 CA Practitioner - Dermatology 6002899242 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Derm Surgery Associates P.a. Dermatology CurrentSince Jun 1, 2015 Accepting new patients
Confermed of California PC CurrentSince May 1, 2024 Accepting new patients
Dermatology Group of SL PA Dermatology PastSince Apr 30, 2003 Accepting new patients
TMH Physician Associates PLLC Past Accepting new patients
Confermed PC Dermatology Past Accepting new patients

Locations

101 Academy
Ste 100
Irvine, CA 92617
Phone (860) 323-0172

4600 Campus Dr
Ste 203
Newport Beach, CA 92660
Phone (617) 259-5933

11 Silver St
Unit 856
Middletown, CT 06457

6700 West Loop S
Ste 500
Bellaire, TX 77401
Phone (713) 791-9966

1910 Niebuhr St
Brenham, TX 77833
Phone (979) 353-4267

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1821099953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778340007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68OO QUEBE RD",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "77833",
            "telephone_number": "713-303-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "CHRISTY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-03",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "L2758",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "L2758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

Verify at the official NPI Registry.