MEDICARE: PREFERRED MOBILE WOUND SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363LF0000X	Family Nurse Practitioner
2	363L00000X	Nurse Practitioner
3	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1184482895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED MOBILE WOUND SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	602 MAGIC MILE ST STE 4
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5108
Country	:	US
Telephone Number	:	337-315-7927
Fax Number	:	833-940-2242

Provider Business Practice Location Address
First Line	:	602 MAGIC MILE ST STE 4
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5108
Country	:	US
Telephone Number	:	337-315-7927
Fax Number	:	833-940-2242

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	RICHARD DAVIS
Credential	:
Telephone Number	:	337-315-7927

Provider Enumeration Date	:	03/07/2024
Last Update Date	:	02/13/2026

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