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General NPI Number Information
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NPI Number | 1184421935
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Entity Type | Organization
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Legal Business Name | QUALITY WOUND CARE LLC
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 105 CRIMSON TREE
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City | CIBOLO
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State | TX
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Zip | 78108-4325
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Country | US
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Telephone | 210-980-4767
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Fax | 210-980-4664
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Provider Business Mailing Address
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Address Line | 105 CRIMSON TREE
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City | CIBOLO
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State | TX
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Zip | 78108-4325
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Country | US
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Telephone | 210-980-4767
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Fax | 210-703-3479
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Authorized Official
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Title or Position | OWNER
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Name | LAUREN WALLS
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Credential | APRN
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Telephone | 936-333-3532
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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