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General NPI Number Information
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NPI Number | 1508119074
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Entity Type | Organization
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Legal Business Name | WOUND AND LYMPHOLOGY OF TEXAS PA
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 08/19/2016
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Provider Practice Location Address
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Address Line | 6411 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-1501
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Country | US
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Telephone | 713-704-5900
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Fax | 713-850-1327
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Provider Business Mailing Address
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Address Line | 3211 PEMBERTON CIRCLE DR
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City | HOUSTON
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State | TX
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Zip | 77025-4334
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Country | US
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Telephone | 832-466-4369
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Fax | 713-850-1327
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIK MAUS
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Credential | M.D.
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Telephone | 832-466-4369
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number |
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License Number State |
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