Provider Demographics
NPI:1912130873
Name:GREENWOOD, DAVID W (APN)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:GREENWOOD
Suffix:
Gender:M
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7703 FLOYD CURL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3901
Mailing Address - Country:US
Mailing Address - Phone:210-567-5555
Mailing Address - Fax:
Practice Address - Street 1:7526 LOUIS PASTEUR DR
Practice Address - Street 2:#339
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4001
Practice Address - Country:US
Practice Address - Phone:210-567-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-26
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX693842363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208866801Medicaid
TX208866803Medicaid
TX208866802Medicaid
TX880N99OtherBCBS
TX208866804Medicaid
TXP00951173OtherRAILROAD
TX208866802Medicaid
TX208866804Medicaid
TXB130163Medicare PIN
TX208866801Medicaid