Organization
JERRY D WOOD
Active
Other names
Jerry Wood, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY D WOOD MD (OWNER)
(936) 327-7147
Entity
Organization
Contact information
Practice address
219 NORTH EASTWOOD AVE, LIVINGSTON, TX 77351
(936) 327-7147
(936) 327-6234
Mailing address
219 NORTH EASTWOOD AVE, LIVINGSTON, TX 77351
(936) 327-7147
(936) 327-6234
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G0304
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00N68X
BLUECROSS BLUE SHIELD
TX
05
—
093953001
—
TX
Enumeration date
09/21/2007
Last updated
06/08/2011
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