Provider Demographics
NPI:1689769333
Name:WOOD, MICHAEL TODD (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:TODD
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:13811 MURPHY RD
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4903
Mailing Address - Country:US
Mailing Address - Phone:713-772-1200
Mailing Address - Fax:713-772-0258
Practice Address - Street 1:7777 SOUTHWEST FWY
Practice Address - Street 2:SUITE 810
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1802
Practice Address - Country:US
Practice Address - Phone:713-772-1200
Practice Address - Fax:713-772-0258
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3954208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5069065OtherCIGNA
TX10026939OtherAMERIGROUP
TX7367232OtherAETNA
TX1450132-01Medicaid
TXP00075520OtherMEDICARE RR
TX8231K1Medicare ID - Type UnspecifiedMD INDIVIDUAL PROVIDER ID
TX7367232OtherAETNA