Provider Demographics
NPI:1114003357
Name:WOOD, STELLA MAE (RRT)
Entity Type:Individual
Prefix:MS
First Name:STELLA
Middle Name:MAE
Last Name:WOOD
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:MISS
Other - First Name:STELLA
Other - Middle Name:MAE
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6914 KEARNEY DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469
Mailing Address - Country:US
Mailing Address - Phone:281-545-2330
Mailing Address - Fax:
Practice Address - Street 1:2002 HOLCOMBE ST
Practice Address - Street 2:MICHAEL E DEBAKEY VAMC HOSPITAL
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-791-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRRT273898171000000X
TX273898246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171000000XOther Service ProvidersMilitary Health Care Provider
Not Answered246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other