Provider Demographics
NPI:1497522411
Name:WOODY, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WOODY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 N IH 35 E STE 310
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-5326
Mailing Address - Country:US
Mailing Address - Phone:469-800-9830
Mailing Address - Fax:469-800-9840
Practice Address - Street 1:2400 N IH 35 E
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-5240
Practice Address - Country:US
Practice Address - Phone:254-459-9199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered