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General NPI Number Information
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NPI Number | 1356153845
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Entity Type | Organization
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Legal Business Name | SOUTHWEST CENTRAL WOUND CARE CLINIC PLLC
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Dates
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Enumeration Date | 01/22/2025
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 1910 PACIFIC AVE STE 8045
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City | DALLAS
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State | TX
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Zip | 75201-4523
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Country | US
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Telephone | 469-574-7757
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Fax |
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Provider Business Mailing Address
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Address Line | 1910 PACIFIC AVE STE 8045
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City | DALLAS
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State | TX
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Zip | 75201-4523
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Country | US
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Telephone | 469-574-7757
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | MURTAZA SHAKIR
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Credential |
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Telephone | 630-538-7009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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Taxonomy #4
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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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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