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General NPI Number Information
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NPI Number | 1265894802
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Entity Type | Organization
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Legal Business Name | PEDS IN A POD, PLLC.
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Dates
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Enumeration Date | 03/23/2016
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Last Update Date | 08/11/2016
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Provider Practice Location Address
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Address Line | 3415 CALDERA BLVD
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City | MIDLAND
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State | TX
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Zip | 79707-2825
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Country | US
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Telephone | 432-704-5455
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Fax | 432-695-6951
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Provider Business Mailing Address
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Address Line | 3415 CALDERA BLVD
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City | MIDLAND
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State | TX
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Zip | 79707-2825
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Country | US
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Telephone | 432-704-5455
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Fax | 432-695-6951
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Authorized Official
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Title or Position | OWNER
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Name | DR. BABRARA JEAN WOOD
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Credential | M.D.
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Telephone | 432-704-5455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | N5488
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License Number State | TX
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