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General NPI Number Information
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NPI Number | 1447480132
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Entity Type | Organization
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Legal Business Name | GLENN WOOD MD PA
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 08/17/2009
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Provider Practice Location Address
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Address Line | 2621 RIDGEPOINT DR STE 130
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City | AUSTIN
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State | TX
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Zip | 78754-5224
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Country | US
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Telephone | 512-892-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 6705 W HWY 290 C1
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City | AUSTIN
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State | TX
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Zip | 78735-8400
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Country | US
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Telephone | 512-892-7200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GLENN WOOD
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Credential | MD
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Telephone | 512-892-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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