Organization Active NPI

Woodlands Heart and Vascular Institute, PA

  • Interventional Cardiology Physician
  • Shenandoah, TX
National Provider Identifier
1982837605
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
K7017 Issued in TX
Legal business name
WOODLANDS HEART AND VASCULAR INSTITUTE, PA
Practice address
920 Medical Plaza Dr
Suite 520
Shenandoah, TX 77380-3260
Phone
(832) 562-3974
Fax
(832) 813-0233
NPI assigned
Aug 27, 2009
Last updated
Jul 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Authorized official

Name
Dr. Laura Fernandes, MDNPI 1811083116
Title
Physician
Phone
(832) 562-3974

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
Interventional Cardiology Physician 207RI0011X K7017 TX Primary

Addresses

Primary practice location

920 Medical Plaza Dr
Suite 520
Shenandoah, TX 77380-3260

Mailing address

920 Medical Plaza Dr
Suite 520
Shenandoah, TX 77380-3260
Phone (832) 562-3974

Other identifiers 1

IdentifierTypeStateIssuer
0021SQOtherTXBLUE CROSS AND BLUE SHIELD OF TX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091203000166 TX Part B Supplier - Clinic/Group Practice 2860531977 Receives reassigned benefits from 6 practitioners
Practice locations: Huntsville, TX; Shenandoah, TX

National Provider Directory

National Provider Directory

Locations

600 River Pointe Dr
Ste 104
Conroe, TX 77304
Phone (936) 756-0404

920 Medical Plaza Dr
Ste 520
Shenandoah, TX 77380
Phone (832) 562-3974

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1982837605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 MEDICAL PLAZA DR",
            "address_2": "SUITE 520",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803260",
            "telephone_number": "832-562-3974",
            "fax_number": "832-813-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MEDICAL PLAZA DR",
            "address_2": "SUITE 520",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773803260",
            "telephone_number": "832-562-3974",
            "fax_number": "832-813-0233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLANDS HEART AND VASCULAR INSTITUTE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "FERNANDES",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "832-562-3974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "K7017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD OF TX",
            "identifier": "0021SQ",
            "state": "TX"
        }
    ],
    "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 Jul 26, 2021; 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.