NPIMap

Organization Active NPI

Glenn Wood MD PA

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1821232281
Registry record updated Apr 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
F4706 Issued in TX
Legal business name
GLENN WOOD MD PA
Practice address
730 W Stassney LN
Austin, TX 78745-2982
Phone
(512) 892-7200
Fax
(512) 892-7205
NPI assigned
Apr 28, 2009
Organization subpart
Yes
Parent organization
GLENN WOOD MD PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 28, 2009

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

Authorized official

Name
Ms. Bea Esquivel
Title
Administrator
Phone
(512) 552-4124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X F4706 TX Primary

Addresses

Primary practice location

730 W Stassney LN
Austin, TX 78745-2982

Mailing address

6705 W Hwy 290
C1
Austin, TX 78735-8400
Phone (512) 892-7200

National Provider Directory

National Provider Directory
Tax ID family
Carousel Pediatrics20 organizations share this tax ID, including this one
Part of
Carousel Pediatrics

Other organizations with this tax ID 19

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

View all 19

Locations

730 W Stassney Ln
Austin, TX 78745
Phone (512) 892-7200

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240876800000",
    "number": "1821232281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6705 W HWY 290",
            "address_2": "C1",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787358400",
            "telephone_number": "512-892-7200",
            "fax_number": "512-892-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 W STASSNEY LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787452982",
            "telephone_number": "512-892-7200",
            "fax_number": "512-892-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN WOOD MD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GLENN WOOD MD PA",
        "enumeration_date": "2009-04-28",
        "last_updated": "2009-04-28",
        "status": "A",
        "authorized_official_last_name": "ESQUIVEL",
        "authorized_official_first_name": "BEA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "512-552-4124",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "F4706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 28, 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.