Basic Information
| Provider Information | |||||||||
| NPI: | 1245596451 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WOFFORD | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | SHAW | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5310 HARVEST HILL RD STE 290 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752305826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2144200650 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8220 WALNUT HILL LN STE 512 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752314414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2143698130 | ||||||||
| FaxNumber: | 2143697872 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2012 | ||||||||
| LastUpdateDate: | 04/04/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | P8568 | TX | Y | Allopathic & Osteopathic Physicians | Dermatology | 207ND0900X | P8568 | TX | N | Allopathic & Osteopathic Physicians | Dermatology | Dermatopathology |
No ID Information.