=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225875313
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEXUS WOUND CONSULTANTS PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2024
-----------------------------------------------------
Last Update Date | 07/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 330 N BRAND BLVD STE 700
-----------------------------------------------------
City | GLENDALE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91203-2336
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 830-285-8882
-----------------------------------------------------
Fax | 830-215-4711
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12703 SPECTRUM DR STE 102
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78249-3444
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 830-285-8882
-----------------------------------------------------
Fax | 830-215-4711
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | SAMUEL JURCA
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 830-285-8882
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------