Healthcare Provider Details

I. General information

NPI: 1912130873
Provider Name (Legal Business Name): DAVID W GREENWOOD APN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 07/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7526 LOUIS PASTEUR DR #339
SAN ANTONIO TX
78229-4001
US

IV. Provider business mailing address

7703 FLOYD CURL DR
SAN ANTONIO TX
78229-3901
US

V. Phone/Fax

Practice location:
  • Phone: 210-567-5555
  • Fax:
Mailing address:
  • Phone: 210-567-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number693842
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: