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NPI Code Detail

MEDICARE: BRENT S WOOD DPM PLLC

MEDICARE: BRENT S WOOD DPM PLLC
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
1261QP1100XPodiatric Clinic/Center1890TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11437403821OTHERNPI,BUSINESS
21669606414OTHERNPI, INDIVIDUAL

General Provider Information

NPI Number : 1437403821
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRENT S WOOD DPM PLLC
Provider Business Mailing Address
First Line : 1502 BLUE RIDGE DR STE 104
Second Line :
City : GEORGETOWN
State : TX
Zip : 78626-1002
Country : US
Telephone Number : 512-719-4545
Fax Number : 512-372-3396
Provider Business Practice Location Address
First Line : 1502 BLUE RIDGE DR STE 104
Second Line :
City : GEORGETOWN
State : TX
Zip : 78626-1002
Country : US
Telephone Number : 512-719-4545
Fax Number : 512-372-3396
Authorized Official
Title or Position : OWNER/MANAGER
Name : DR. BRENT WOOD
Credential : D.P.M.
Telephone Number : 512-719-4545
Provider Enumeration Date : 11/07/2012
Last Update Date : 04/30/2025

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Practice Fax: 512-372-3396

Directions to “BRENT S WOOD DPM PLLC ” Practice Location

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