Healthcare Provider Details

I. General information

NPI: 1154686491
Provider Name (Legal Business Name): REBECCA NAOMI WOOD-HORRALL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. REBECCA NAOMI WOOD

II. Dates (important events)

Enumeration Date: 07/12/2012
Last Update Date: 02/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HIGHWAY 71 E
SMITHVILLE TX
78957-1730
US

IV. Provider business mailing address

800 HIGHWAY 71 E
SMITHVILLE TX
78957-1730
US

V. Phone/Fax

Practice location:
  • Phone: 512-237-5736
  • Fax: 512-237-5704
Mailing address:
  • Phone: 512-237-5736
  • Fax: 512-237-5704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberP6553
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: