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General NPI Number Information
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NPI Number | 1316897416
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Entity Type | Organization
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Legal Business Name | PRIME WOUND CARE CLINIC LLC
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 1000 GATTIS SCHOOL RD STE 430
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City | ROUND ROCK
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State | TX
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Zip | 78664-2569
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Country | US
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Telephone | 512-740-8993
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Fax | 833-974-2451
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Provider Business Mailing Address
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Address Line | 1000 GATTIS SCHOOL RD STE 430
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City | ROUND ROCK
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State | TX
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Zip | 78664-2569
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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 | OWNER
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Name | LITTY VADAKKAN
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Credential | NP
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Telephone | 512-740-8993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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