Healthcare Provider Details

I. General information

NPI: 1588266605
Provider Name (Legal Business Name): VAYU ADVANCED WOUND CLINIC AND HYPERBARICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8666 HUEBNER RD STE 220
SAN ANTONIO TX
78240-1837
US

IV. Provider business mailing address

13423 BLANCO RD # 767
SAN ANTONIO TX
78216-2187
US

V. Phone/Fax

Practice location:
  • Phone: 210-651-1112
  • Fax: 855-479-2049
Mailing address:
  • Phone: 210-651-1112
  • Fax: 855-479-2049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MANJULATHA BADAM
Title or Position: PHYSICIAN
Credential: MD, CWSP, UHM
Phone: 210-651-1112