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NPI Code Detail

MEDICARE: JEFFERY B WOOD

MEDICARE:   JEFFERY B WOOD
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
1152W00000XOptometrist3241TGTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548359045
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFERY B WOOD
Provider Business Mailing Address
First Line : 321 N ALLEN DR
Second Line :
City : ALLEN
State : TX
Zip : 75013-2539
Country : US
Telephone Number : 972-727-5717
Fax Number : 972-727-9927
Provider Business Practice Location Address
First Line : 321 N ALLEN DR
Second Line :
City : ALLEN
State : TX
Zip : 75013-2539
Country : US
Telephone Number : 972-727-5717
Fax Number : 972-727-9927
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 06/22/2012

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Directions to “ JEFFERY B WOOD ” Practice Location

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