NPIMap

Organization Active NPI

Glenn Wood MD PA

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1770712804
Registry record updated Jul 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GLENN WOOD MD PA
Practice address
6425 S Ih 35
100
Austin, TX 78744-4271
Phone
(512) 788-4801
NPI assigned
Jul 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2009

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

Authorized official

Name
Ms. Rebecca R Perez
Title
Credentialer
Phone
(512) 788-4801

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

6425 S Ih 35
100
Austin, TX 78744-4271

Mailing address

6705 W Highway 290
C1
Austin, TX 78735-8400
Phone (512) 788-4801

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

6425 S Interstate 35
Ste 100
Austin, TX 78744

NPI Registry JSON

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247184000000",
    "number": "1770712804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6705 W HIGHWAY 290",
            "address_2": "C1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358400",
            "telephone_number": "512-788-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6425 S IH 35",
            "address_2": "100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787444271",
            "telephone_number": "512-788-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN WOOD MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-10",
        "last_updated": "2009-07-10",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CREDENTIALER",
        "authorized_official_telephone_number": "512-788-4801",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-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 Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; 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.