MEDICARE: EDWIN C. WOOD, M.D., P.A.

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	261Q00000X	Clinic/Center	E0195	TX

General Provider Information

NPI Number	:	1144339375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDWIN C. WOOD, M.D., P.A.

Provider Business Mailing Address
First Line	:	3642 UNIVERSITY BLVD
Second Line	:	STE. 201
City	:	HOUSTON
State	:	TX
Zip	:	77005-3360
Country	:	US
Telephone Number	:	713-667-1830
Fax Number	:	713-520-8139

Provider Business Practice Location Address
First Line	:	3642 UNIVERSITY BLVD
Second Line	:	STE. 201
City	:	HOUSTON
State	:	TX
Zip	:	77005-3360
Country	:	US
Telephone Number	:	713-667-1830
Fax Number	:	713-520-8139

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EDWIN CHARLES WOOD
Credential	:	M.D.
Telephone Number	:	713-667-1830

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	08/22/2020

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