NPIMap

Organization Active NPI

Glenn Wood MD PA

  • Pediatrics Physician
  • Austin, TX
National Provider Identifier
1861704280
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GLENN WOOD MD PA
Practice address
9411 N Lamar Blvd
Austin, TX 78753-4178
Phone
(512) 744-6000
Fax
(512) 892-7205
NPI assigned
Jul 14, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Authorized official

Name
Karen Cantu
Title
Credentialing Specialist
Phone
(512) 334-5978

Specialties & licenses 1

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

Addresses

Primary practice location

9411 N Lamar Blvd
Austin, TX 78753-4178

Mailing address

2621 Ridgepoint Dr
Suite 130
Austin, TX 78754-5232
Phone (512) 744-6000

Other names 1

  • CAROUSEL PEDIATRICS Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2020878Carousel Pediatrics9411 N Lamar Blvd Ste 120, Austin, TX 78753Certificate of waiverAug 28, 2026

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

NPI Registry JSON

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279065600000",
    "number": "1861704280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2621 RIDGEPOINT DR",
            "address_2": "SUITE 130",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787545232",
            "telephone_number": "512-744-6000",
            "fax_number": "512-892-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9411 N LAMAR BLVD",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787534178",
            "telephone_number": "512-744-6000",
            "fax_number": "512-892-7205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN WOOD MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-14",
        "last_updated": "2010-07-14",
        "status": "A",
        "authorized_official_last_name": "CANTU",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "512-334-5978"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE 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 Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.