Provider Demographics
NPI:1144236712
Name:WOOD, PAMELA R (MD)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:R
Last Name:WOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-562-5344
Mailing Address - Fax:210-562-5319
Practice Address - Street 1:333 N. SANTA ROSA ST
Practice Address - Street 2:3RD FLOOR- CHILDREN'S HEALTH CENTER
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207
Practice Address - Country:US
Practice Address - Phone:210-562-5300
Practice Address - Fax:210-562-5342
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4755208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111832502OtherCIDC
TX111832501Medicaid
TX111832501Medicaid