MEDICARE: GLENN WOOD MD PA

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	208000000X	Pediatrics Physician

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235356114
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GLENN WOOD MD PA

Provider Business Mailing Address
First Line	:	2410 E RIVERSIDE DR
Second Line	:	STE G3
City	:	AUSTIN
State	:	TX
Zip	:	78741-3083
Country	:	US
Telephone Number	:	512-448-4433
Fax Number	:	512-448-3776

Provider Business Practice Location Address
First Line	:	2410 E RIVERSIDE DR
Second Line	:	STE G3
City	:	AUSTIN
State	:	TX
Zip	:	78741-3083
Country	:	US
Telephone Number	:	512-448-4433
Fax Number	:	512-448-3776

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. GLENN G WOOD
Credential	:	M.D.
Telephone Number	:	512-448-4433

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	06/30/2008

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Directions to “GLENN WOOD MD PA ” Practice Location

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