NPIMap

Organization Active NPI

Glenn Wood MD PA

  • Pediatrics Physician
  • Round Rock, TX
National Provider Identifier
1194264416
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GLENN WOOD MD PA
Doing business as
Carousel Pediatrics
Practice address
1201 S Interstate 35 Ste 303
Round Rock, TX 78664-6651
Phone
(512) 744-6000
NPI assigned
Feb 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Authorized official

Name
Angela Kilcollins
Title
Credentialing Administrator
Phone
(512) 583-9679

Specialties & licenses 1

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

Addresses

Primary practice location

1201 S Interstate 35 Ste 303
Round Rock, TX 78664-6651

Mailing address

9411 N Lamar Blvd Ste 120
Austin, TX 78753-4179
Phone (512) 583-9679

Other names 1

  • Carousel Pediatrics Doing business as

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

9411 N Lamar Blvd
Ste 120
Austin, TX 78753
Phone (512) 583-9679

NPI Registry JSON

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

{
    "created_epoch": "1487548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487548800000",
    "number": "1194264416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9411 N LAMAR BLVD STE 120",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787534179",
            "telephone_number": "512-583-9679",
            "fax_number": "512-233-0985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S INTERSTATE 35 STE 303",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786646651",
            "telephone_number": "512-744-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN WOOD MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-20",
        "last_updated": "2017-02-20",
        "status": "A",
        "authorized_official_last_name": "KILCOLLINS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CREDENTIALING ADMINISTRATOR",
        "authorized_official_telephone_number": "512-583-9679"
    },
    "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": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.