Provider Demographics
NPI:1265894802
Name:PEDS IN A POD, PLLC.
Entity type:Organization
Organization Name:PEDS IN A POD, PLLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BABRARA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-704-5455
Mailing Address - Street 1:3415 CALDERA BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-2825
Mailing Address - Country:US
Mailing Address - Phone:432-704-5455
Mailing Address - Fax:432-695-6951
Practice Address - Street 1:3415 CALDERA BLVD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-2825
Practice Address - Country:US
Practice Address - Phone:432-704-5455
Practice Address - Fax:432-695-6951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-23
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5488208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty