| Woodlands Diagnostic Clinic, Pa | |
|
9201 Pinecroft Dr Ste 200 Shenandoah TX 77380-3889 | |
| (281) 863-9554 | |
| Not Available |
| Full Name | Woodlands Diagnostic Clinic, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 9201 Pinecroft Dr Ste 200, Shenandoah, Texas |
| Authorized Official Name and Position | Tammie Rogers (DIRECTOR) |
| Authorized Official Contact | 2818639554 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodlands Diagnostic Clinic, Pa 9201 Pinecroft Dr Ste 200 Shenandoah TX 77380-3889 Ph: (281) 863-9554 | Woodlands Diagnostic Clinic, Pa 9201 Pinecroft Dr Ste 200 Shenandoah TX 77380-3889 Ph: (281) 863-9554 |
| NPI Number | 1336753508 |
|---|---|
| Provider Enumeration Date | 09/03/2020 |
| Last Update Date | 08/07/2023 |
| Medicare PECOS PAC ID | 1456762863 |
|---|---|
| Medicare Enrollment ID | O20201116000969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336753508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
| Provider Name | William A Fridley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760456545 PECOS PAC ID: 3870405376 Enrollment ID: I20031104000209 |
| Provider Name | Maria Charron |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1073574091 PECOS PAC ID: 5092788653 Enrollment ID: I20040813000101 |
| Provider Name | Todd J Youngblood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912919473 PECOS PAC ID: 9830100445 Enrollment ID: I20060510000628 |
| Provider Name | Stephen D Fillman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992779961 PECOS PAC ID: 6002728508 Enrollment ID: I20101029001273 |
| Provider Name | Patrick T Ogidan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629367602 PECOS PAC ID: 1254553811 Enrollment ID: I20141114000966 |
| Provider Name | Sharon Ogidan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659727105 PECOS PAC ID: 5092047860 Enrollment ID: I20191028001977 |
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