Provider Demographics
NPI:1902840903
Name:WOOD, RICHARD E (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:E
Last Name:WOOD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3600 GASTON AVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-827-3890
Mailing Address - Fax:214-823-9310
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:SUITE 404
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1800
Practice Address - Country:US
Practice Address - Phone:214-827-3890
Practice Address - Fax:214-823-9310
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2009-06-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXD6350208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX034472302Medicaid
NM65759869OtherNM MEDICAID
TX034472304Medicaid
TX8H3702OtherBCBS
TX8AA834OtherBCBSTX
TX034472303Medicaid
TX8AA834OtherBCBSTX
TX8K0581Medicare PIN