Healthcare Provider Details

I. General information

NPI: 1841733235
Provider Name (Legal Business Name): ERIN WOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2016
Last Update Date: 12/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6010 W AMARILLO BLVD
AMARILLO TX
79106-1990
US

IV. Provider business mailing address

6010 W AMARILLO BLVD
AMARILLO TX
79106-1990
US

V. Phone/Fax

Practice location:
  • Phone: 806-355-9703
  • Fax: 806-356-3783
Mailing address:
  • Phone: 806-355-9703
  • Fax: 806-356-3783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number53985
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: