Healthcare Provider Details

I. General information

NPI: 1992502421
Provider Name (Legal Business Name): MOBILE WOUND CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 TEAGUE DR STE 219
SHERMAN TX
75090-2640
US

IV. Provider business mailing address

2424 SPRINGER DR STE 300
NORMAN OK
73069-3966
US

V. Phone/Fax

Practice location:
  • Phone: 903-357-5320
  • Fax: 903-524-0873
Mailing address:
  • Phone: 903-357-5320
  • Fax: 903-524-0873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TERRY GRAY
Title or Position: OWNER
Credential:
Phone: 405-920-8035