Provider Demographics
NPI:1912990979
Name:WOOD, YING YING PENG (MD)
Entity Type:Individual
Prefix:DR
First Name:YING YING
Middle Name:PENG
Last Name:WOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6445 HIGHSTAR DRIVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-5005
Mailing Address - Country:US
Mailing Address - Phone:713-777-1117
Mailing Address - Fax:713-777-2226
Practice Address - Street 1:6445 HIGHSTAR DRIVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-5005
Practice Address - Country:US
Practice Address - Phone:713-777-1117
Practice Address - Fax:713-777-2226
Is Sole Proprietor?:No
Enumeration Date:2005-08-25
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1155208000000X, 208D00000X
TXAC01622171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126890606Medicaid
TX126890605Medicaid
TX126890604Medicaid