NPIMap

Organization Active NPI

Glenn Wood MD PA

  • Pediatrics Physician
  • Mercedes, TX
National Provider Identifier
1043581275
Registry record updated Jan 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GLENN WOOD MD PA
Practice address
109 S Texas Ave
Ste E
Mercedes, TX 78570-2725
Phone
(512) 744-6000
NPI assigned
Jan 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Traci Dixson
Title
Director of Operations
Phone
(512) 583-9680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

109 S Texas Ave
Ste E
Mercedes, TX 78570-2725

Mailing address

2621 Ridgepoint Dr
Ste 130
Austin, TX 78754-5232
Phone (512) 583-9679

Other names 1

  • Carousel Pediatrics Other name

National Provider Directory

National Provider Directory
Tax ID family
Glenn Wood MD PA20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

109 S Texas Ave
Ste E
Mercedes, TX 78570
Phone (956) 514-1643

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326931200000",
    "number": "1043581275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 RIDGEPOINT DR",
            "address_2": "STE 130",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787545232",
            "telephone_number": "512-583-9679",
            "fax_number": "512-334-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S TEXAS AVE",
            "address_2": "STE E",
            "city": "MERCEDES",
            "state": "TX",
            "postal_code": "785702725",
            "telephone_number": "512-744-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN WOOD MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-19",
        "last_updated": "2012-01-19",
        "status": "A",
        "authorized_official_last_name": "DIXSON",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "512-583-9680"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carousel Pediatrics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mercedes, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.