Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | J6820 | TX |
N | 207XS0117X | Orthopaedic Spine Surgeon | J6820 | TX |
NPI | 1356339832 |
---|---|
Provider Name | Jeffrey Ben Wood |
First Address | Sugar Land, TX 77479-4728 |
Second Address | Sugar Land, TX 77479-4728 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2005 |
Last Update Date | 30/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
145723601 | (05) | TX |
145723602 | (05) | TX |
145723603 | (05) | TX |
145723604 | (05) | TX |
145723605 | (05) | TX |
145723606 | (05) | TX |
2122274 | (05) | LA |
610119705 | US DEPT OF LABOR (01) | TX |
8BP170 | BLUE CROSS BLUE SHIELD (01) | TX |
G98445 | (02) | |
P00663449 | MEDICARE RAILROAD (01) | TX |
P01055728 | RR MEDICARE (01) | TX |