Healthcare Provider Details
I. General information
NPI: 1003993643
Provider Name (Legal Business Name): DFW WOUND & HYPERBARICS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/01/2006
Last Update Date: 07/26/2022
Certification Date: 07/26/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3500 W WHEATLAND RD
DALLAS TX
75237-3460
US
IV. Provider business mailing address
PO BOX 975461
DALLAS TX
75397-5461
US
V. Phone/Fax
- Phone: 214-947-0752
- Fax: 214-947-0751
- Phone: 972-786-0340
- Fax: 972-786-0142
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2083P0011X |
| Taxonomy | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician |
| License Number | M0340 |
| License Number State | TX |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2083P0011X |
| Taxonomy | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BASIT
ALI
Title or Position: D.O
Credential: D.O
Phone: 214-947-0752