Provider Demographics
NPI:1487640744
Name:WOOD, KATHRYN JO (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:JO
Last Name:WOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:WOOD
Other - Last Name:ZENTHOEFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3550 PARKWOOD BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-1903
Mailing Address - Country:US
Mailing Address - Phone:972-769-9663
Mailing Address - Fax:972-769-9664
Practice Address - Street 1:3550 PARKWOOD BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1903
Practice Address - Country:US
Practice Address - Phone:972-769-9663
Practice Address - Fax:972-769-9664
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9363207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG9363OtherSTATE MEDICAL LICENSE
TX00A62ROtherBC/BS
TXC23745Medicare UPIN
TXG9363OtherSTATE MEDICAL LICENSE