Provider Demographics
NPI:1255351227
Name:WOOD, GINGER D (MPT)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:D
Last Name:WOOD
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1633 COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-3033
Mailing Address - Country:US
Mailing Address - Phone:325-672-4372
Mailing Address - Fax:
Practice Address - Street 1:1220 N MALINCHE AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-3354
Practice Address - Country:US
Practice Address - Phone:956-722-2431
Practice Address - Fax:956-722-7553
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1164580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T7892OtherBCBS