Provider Demographics
NPI:1093771842
Name:WOODLAND, CAROLINE ELIZABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:ELIZABETH
Last Name:WOODLAND
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5701 BRYANT IRVIN RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4029
Mailing Address - Country:US
Mailing Address - Phone:817-361-5037
Mailing Address - Fax:817-361-5031
Practice Address - Street 1:5701 BRYANT IRVIN RD
Practice Address - Street 2:SUITE 304
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4029
Practice Address - Country:US
Practice Address - Phone:817-361-5037
Practice Address - Fax:817-361-5031
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9014207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111997604Medicaid
TX8706B2OtherBC/BS
TX080180291Medicare PIN
TX8706B2OtherBC/BS
TXF90873Medicare UPIN