Healthcare Provider Details

I. General information

NPI: 1700336070
Provider Name (Legal Business Name): DR. BARRIE WOOD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 11/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 OLIVE ST
SAN MARCOS TX
78666-4164
US

IV. Provider business mailing address

114 OLIVE ST
SAN MARCOS TX
78666-4164
US

V. Phone/Fax

Practice location:
  • Phone: 512-787-1551
  • Fax:
Mailing address:
  • Phone: 512-787-1551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: