Provider Demographics
NPI:1639162746
Name:WOOD, DAVID ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROBERT
Last Name:WOOD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4411 E SOUTHCROSS BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-3726
Mailing Address - Country:US
Mailing Address - Phone:210-648-9500
Mailing Address - Fax:210-648-9504
Practice Address - Street 1:4411 E SOUTHCROSS BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3726
Practice Address - Country:US
Practice Address - Phone:210-648-9500
Practice Address - Fax:210-648-9504
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7382207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX097240802Medicaid
TX83V781OtherBCBS
TX00L82GMedicare PIN
TX83V781OtherBCBS