Healthcare Provider Details

I. General information

NPI: 1548232119
Provider Name (Legal Business Name): DENISE ANN WOODY-GROSS M.D., P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 11/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7711 LOUIS PASTEUR SUITE 410
SAN ANTONIO TX
78229-3415
US

IV. Provider business mailing address

7711 LOUIS PASTEUR SUITE 410
SAN ANTONIO TX
78229-3415
US

V. Phone/Fax

Practice location:
  • Phone: 210-593-0620
  • Fax: 210-615-8027
Mailing address:
  • Phone: 210-593-0620
  • Fax: 210-615-8027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberJ8844
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: