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General NPI Number Information
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NPI Number | 1497591135
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Entity Type | Organization
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Legal Business Name | NEXUS WOUND CONSULTANTS -LOUISIANA LLC
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Dates
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Enumeration Date | 07/02/2024
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Last Update Date | 07/05/2024
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Provider Practice Location Address
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Address Line | 3867 PLAZA TOWER DR
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City | BATON ROUGE
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State | LA
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Zip | 70816-4378
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Country | US
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Telephone | 830-285-8882
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Fax | 830-215-4711
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Provider Business Mailing Address
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Address Line | PO BOX 738652
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City | DALLAS
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State | TX
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Zip | 75373-8652
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Country | US
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Telephone | 830-285-8882
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Fax | 830-215-4711
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Authorized Official
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Title or Position | DO/OWNER
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Name | SAMUEL JURCA
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Credential | DO
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Telephone | 830-285-8882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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