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General NPI Number Information
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NPI Number | 1427912641
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Entity Type | Organization
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Legal Business Name | SOUTHLAKE WOUND CARE AND HYPERBARICS
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Dates
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Enumeration Date | 12/11/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 431 E STATE HIGHWAY 114 STE 160
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City | SOUTHLAKE
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State | TX
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Zip | 76092-4412
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Country | US
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Telephone | 877-396-3442
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Fax |
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Provider Business Mailing Address
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Address Line | 431 E STATE HIGHWAY 114 STE 160
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City | SOUTHLAKE
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State | TX
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Zip | 76092-4412
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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 | CREDENTIALING
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Name | CHRISTINE BEARD
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Credential |
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Telephone | 724-986-0771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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