Provider Demographics
NPI:1578590154
Name:WOOD, DAVID A (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 DATAPOINT DR STE 600
Mailing Address - Street 2:P. O. BOX 29407
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5907
Mailing Address - Country:US
Mailing Address - Phone:210-616-7700
Mailing Address - Fax:210-616-7709
Practice Address - Street 1:8401 DATAPOINT DR STE 600
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5907
Practice Address - Country:US
Practice Address - Phone:210-616-7700
Practice Address - Fax:210-616-7709
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK13242085R0202X, 2085N0700X, 2085B0100X, 2085D0003X, 2085U0001X, 2085N0904X, 2085P0229X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2154809-03Medicaid
TXP00878879OtherRAILROAD MEDICARE
TXK1324OtherTEXAS MEDICAL LICENSE
TX2154809-02Medicaid
TXP00878894OtherRAILROAD MEDICARE
TX2154809-01Medicaid
TX2154809-01Medicaid
TXTXB109880Medicare PIN