Organization
LARRY K WOOD MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY KEITH WOOD MD (PRESIDENT)
(903) 465-2020
Entity
Organization
Contact information
Practice address
1014 MEMORIAL DR, SUITE 300, DENISON, TX 75020-2079
(903) 465-2020
(903) 465-1606
Mailing address
1014 MEMORIAL DR, SUITE 300, DENISON, TX 75020-2079
(903) 465-2020
(903) 465-1606
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
H8526
TX
332H00000X
Eyewear Supplier
H8526
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0032HD
BLUE CROSS
TX
01
—
100755440A
MEDICAID
OK
05
—
148685401
—
TX
Enumeration date
08/09/2005
Last updated
11/21/2013
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