Organization
GLENN WOOD MD PA
Active
Other names
Carousel Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REBECCA R PEREZ (CREDENTIALER)
(512) 788-4801
Entity
Organization
Contact information
Practice address
6425 S IH 35, 100, AUSTIN, TX 78744-4271
(512) 788-4801
Mailing address
6705 W HIGHWAY 290, C1, AUSTIN, TX 78735-8400
(512) 788-4801
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
07/10/2009
Last updated
07/10/2009
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