Healthcare Provider Details

I. General information

NPI: 1174217947
Provider Name (Legal Business Name): GLOBAL OPEN WOUND CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8100 N MAY AVE
OKLAHOMA CITY OK
73120-4545
US

IV. Provider business mailing address

521 W SOUTHLAKE BLVD STE 150
SOUTHLAKE TX
76092-6174
US

V. Phone/Fax

Practice location:
  • Phone: 405-461-6001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: GARY HOLLINGSWORTH
Title or Position: PRESIDENT/CEO
Credential:
Phone: 817-328-3000