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Individual

DR. RUSSELL L WOODARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8122 DATAPOINT DR STE 320, SAN ANTONIO, TX 78229-3264
(210) 614-5113
(210) 616-0024
Mailing address
8122 DATAPOINT DR STE 320, SAN ANTONIO, TX 78229-3264
(210) 614-5113
(210) 616-0024

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
J5065
TX
208600000X
Surgery Physician
Primary
J5065
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103615401
TX
Enumeration date
07/10/2006
Last updated
10/04/2019
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