Healthcare Provider Details

I. General information

NPI: 1003872425
Provider Name (Legal Business Name): KRISTIN D WOODS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTIN D ZUNIGA PA-C

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1806 QUINCY ST
PLAINVIEW TX
79072
US

IV. Provider business mailing address

PO BOX 3158
PORTLAND OR
97208-3158
US

V. Phone/Fax

Practice location:
  • Phone: 806-288-7891
  • Fax: 806-288-7920
Mailing address:
  • Phone: 541-732-8000
  • Fax: 806-288-7920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA04607
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA188159
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: