MEDICARE: MRS. SHARON WOODY PA-C

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	363AM0700X	Medical Physician Assistant	PA05538	TX

General Provider Information

NPI Number	:	1063575116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON WOODY PA-C

Provider Business Mailing Address
First Line	:	2618 ROGERS FRK
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4607
Country	:	US
Telephone Number	:	210-231-0459
Fax Number	:

Provider Business Practice Location Address
First Line	:	7909 FREDERICKSBURG RD STE 110
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-3400
Country	:	US
Telephone Number	:	210-614-4544
Fax Number	:

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

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	09/27/2013

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