Healthcare Provider Details

I. General information

NPI: 1962215657
Provider Name (Legal Business Name): CAMERON WOOD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W MEDICAL CENTER BLVD
WEBSTER TX
77598-4220
US

IV. Provider business mailing address

500 W MEDICAL CENTER BLVD
WEBSTER TX
77598-4220
US

V. Phone/Fax

Practice location:
  • Phone: 281-332-2511
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1076856
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: