Organization
GLENN WOOD MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REBECCA RENE PEREZ (CREDENTIALER)
(512) 788-4801
Entity
Organization
Contact information
Practice address
7112 ED BLUESTEIN BLVD, 100, AUSTIN, TX 78723-2900
(512) 892-7200
Mailing address
6705 W HWY 290, C1, AUSTIN, TX 78735-8400
(512) 788-4801
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153715108
—
TX
Enumeration date
06/16/2009
Last updated
06/24/2009
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