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General NPI Number Information
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NPI Number | 1174217947
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Entity Type | Organization
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Legal Business Name | GLOBAL OPEN WOUND CARE LLC
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 06/05/2023
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Provider Practice Location Address
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Address Line | 8100 N MAY AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-4545
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Country | US
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Telephone | 405-461-6001
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Fax |
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Provider Business Mailing Address
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Address Line | 521 W SOUTHLAKE BLVD STE 150
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6174
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | GARY HOLLINGSWORTH
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Credential |
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Telephone | 817-328-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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