Provider Demographics
NPI:1881089696
Name:WOOD, RITA GOLIKERI (DO)
Entity type:Individual
Prefix:DR
First Name:RITA
Middle Name:GOLIKERI
Last Name:WOOD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:RITA
Other - Middle Name:SUDHIR
Other - Last Name:GOLIKERI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1425 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4151
Mailing Address - Country:US
Mailing Address - Phone:817-926-4118
Mailing Address - Fax:
Practice Address - Street 1:1425 8TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4151
Practice Address - Country:US
Practice Address - Phone:817-926-4118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXR2600207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty