Healthcare Provider Details

I. General information

NPI: 1457643801
Provider Name (Legal Business Name): ERICA L. WOOD PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERICA L PFANNENSTIEL

II. Dates (important events)

Enumeration Date: 05/04/2011
Last Update Date: 08/25/2023
Certification Date: 08/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 3RD ST W BLDG 1040
JBSA RANDOLPH TX
78150-4800
US

IV. Provider business mailing address

229 GRUENE HVN
NEW BRAUNFELS TX
78132-3368
US

V. Phone/Fax

Practice location:
  • Phone: 210-916-9900
  • Fax:
Mailing address:
  • Phone: 207-991-3775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number56587
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPR5414
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: