MEDICARE: PEAK WOUND CARE LLC

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1982567772
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEAK WOUND CARE LLC

Provider Business Mailing Address
First Line	:	1603 CAPITOL AVE STE 413
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82001-4562
Country	:	US
Telephone Number	:	817-440-3361
Fax Number	:	972-947-5381

Provider Business Practice Location Address
First Line	:	12700 HILL CREST RD. SUITE 145
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230
Country	:	US
Telephone Number	:	817-440-3361
Fax Number	:	972-947-5381

Authorized Official
Title or Position	:	OWNER
Name	:	BILAWAL AHMED
Credential	:
Telephone Number	:	817-440-3361

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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