MEDICARE: ALLISON WOODWARD

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	01055487A	IN

General Provider Information

NPI Number	:	1487643805
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON WOODWARD

Provider Business Mailing Address
First Line	:	19507 HIGHGROVE LN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-7286
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3851 ROGER BROOKE DR
Second Line	:
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234-4501
Country	:	US
Telephone Number	:	210-916-4241
Fax Number	:

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	07/08/2007

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Directions to “ ALLISON WOODWARD ” Practice Location

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