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General NPI Number Information
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NPI Number | 1215587977
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Entity Type | Organization
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Legal Business Name | TEXAS WOUND PROS LLC
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Dates
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Enumeration Date | 09/16/2019
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Last Update Date | 09/17/2021
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Provider Practice Location Address
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Address Line | 4601 OLD SHEPARD PL STE 302
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City | PLANO
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State | TX
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Zip | 75093-5279
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Country | US
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Telephone | 469-606-0010
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Fax | 949-404-8632
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Provider Business Mailing Address
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Address Line | 4601 OLD SHEPARD PL STE 302
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City | PLANO
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State | TX
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Zip | 75093-5279
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Country | US
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Telephone | 469-606-0100
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Fax | 949-404-8632
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Authorized Official
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Title or Position | CEO/OWNER
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Name | HOPE JACOBY
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Credential | DPM
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Telephone | 904-252-7808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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