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General NPI Number Information
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NPI Number | 1144339375
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Entity Type | Organization
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Legal Business Name | EDWIN C. WOOD, M.D., P.A.
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3642 UNIVERSITY BLVD STE. 201
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City | HOUSTON
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State | TX
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Zip | 77005-3360
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Country | US
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Telephone | 713-667-1830
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Fax | 713-520-8139
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Provider Business Mailing Address
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Address Line | 3642 UNIVERSITY BLVD STE. 201
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City | HOUSTON
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State | TX
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Zip | 77005-3360
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Country | US
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Telephone | 713-667-1830
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Fax | 713-520-8139
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWIN CHARLES WOOD
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Credential | M.D.
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Telephone | 713-667-1830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | E0195
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License Number State | TX
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