MEDICARE: WOUND PHARM, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LG0600X	Gerontology Nurse Practitioner

General Provider Information

NPI Number	:	1194697755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOUND PHARM, PLLC

Provider Business Mailing Address
First Line	:	6420 LA PAZ RANCH RD
Second Line	:
City	:	MIDLOTHIAN
State	:	TX
Zip	:	76065-7287
Country	:	US
Telephone Number	:	972-903-4343
Fax Number	:	972-903-4343

Provider Business Practice Location Address
First Line	:	6420 LA PAZ RANCH RD
Second Line	:
City	:	MIDLOTHIAN
State	:	TX
Zip	:	76065-7287
Country	:	US
Telephone Number	:	972-903-4343
Fax Number	:	972-903-4343

Authorized Official
Title or Position	:	OWNER
Name	:	KIMBERLY NEELY
Credential	:	NP
Telephone Number	:	972-903-4343

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	01/20/2026

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