Provider Demographics
NPI:1104366749
Name:WOOD, LANCE CHRISTOPHER (AGACNP-BC)
Entity Type:Individual
Prefix:MR
First Name:LANCE
Middle Name:CHRISTOPHER
Last Name:WOOD
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 44
Mailing Address - Street 2:400 MT. WILLOW
Mailing Address - City:VILLAGE MILLS
Mailing Address - State:TX
Mailing Address - Zip Code:77663-0044
Mailing Address - Country:US
Mailing Address - Phone:409-658-7725
Mailing Address - Fax:
Practice Address - Street 1:22999 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-4412
Practice Address - Country:US
Practice Address - Phone:281-348-8956
Practice Address - Fax:281-348-8444
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133442363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care