| Carol A. Wood D.o., Pa | |
|
1751 Broad Park Circle South Suite 203 Mansfield TX 76063 | |
| (817) 539-7377 | |
| Not Available |
| Full Name | Carol A. Wood D.o., Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1751 Broad Park Circle South, Mansfield, Texas |
| Authorized Official Name and Position | Carol A. Wood (PRESIDENT) |
| Authorized Official Contact | 8175397377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carol A. Wood D.o., Pa 1807 Valley View Dr Cedar Hill TX 75104-7843 Ph: (817) 539-7377 | Carol A. Wood D.o., Pa 1751 Broad Park Circle South Suite 203 Mansfield TX 76063 Ph: (817) 539-7377 |
| NPI Number | 1245410356 |
|---|---|
| Provider Enumeration Date | 11/06/2007 |
| Last Update Date | 11/06/2007 |
| Medicare PECOS PAC ID | 8921189705 |
|---|---|
| Medicare Enrollment ID | O20080117000686 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245410356 | NPI | - | NPPES |
| 1942220975 | Other | TX | PROVIDER INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | L9965 (Texas) | Primary |
| Provider Name | Carol A Wood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942220975 PECOS PAC ID: 3476577396 Enrollment ID: I20060118000933 |
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