Provider Demographics
NPI:1548232119
Name:WOODY-GROSS, DENISE ANN (MD, PA)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ANN
Last Name:WOODY-GROSS
Suffix:
Gender:F
Credentials:MD, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7711 LOUIS PASTEUR
Mailing Address - Street 2:SUITE 410
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3415
Mailing Address - Country:US
Mailing Address - Phone:210-593-0620
Mailing Address - Fax:210-615-8027
Practice Address - Street 1:7711 LOUIS PASTEUR
Practice Address - Street 2:SUITE 410
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3415
Practice Address - Country:US
Practice Address - Phone:210-593-0620
Practice Address - Fax:210-615-8027
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8844207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160240101Medicaid
TXG65743Medicare UPIN
TX8A6539Medicare ID - Type UnspecifiedMEDICARE INDIVIDUAL #