MEDICARE: DR. ANDRA CROSS WOODARD DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	13244	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033209168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDRA CROSS WOODARD DDS

Provider Business Mailing Address
First Line	:	PO BOX 8747
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77249-8747
Country	:	US
Telephone Number	:	713-692-9486
Fax Number	:

Provider Business Practice Location Address
First Line	:	3550 W DALLAS ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-1702
Country	:	US
Telephone Number	:	713-525-8846
Fax Number	:	713-525-8463

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	06/24/2016

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