Provider Demographics
NPI:1134539570
Name:WOODARD, ROBERT A II (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:WOODARD
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 PARKING WAY ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5226
Mailing Address - Country:US
Mailing Address - Phone:979-292-8032
Mailing Address - Fax:
Practice Address - Street 1:209 PARKING WAY ST
Practice Address - Street 2:SUITE B
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5226
Practice Address - Country:US
Practice Address - Phone:979-292-8032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2017-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX362694ZZXPOtherMEDICARE
TX362694ZZXPOtherMEDICARE