Individual
DR. CHARLES P. WOODRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
616 W RUSSELL PL, SAN ANTONIO, TX 78212-3658
(800) 257-8715
(800) 819-1655
Mailing address
7011 SUGAR OAKS CT, RICHMOND, TX 77469-7525
(281) 494-5337
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
22075
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86829A
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/18/2006
Last updated
07/08/2007
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