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General NPI Number Information
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NPI Number | 1710631676
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Entity Type | Organization
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Legal Business Name | DYNAMIC WOUND CARE
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Dates
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Enumeration Date | 02/09/2022
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 13207 HUNTERS LARK ST
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City | SAN ANTONIO
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State | TX
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Zip | 78230-2017
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Country | US
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Telephone | 800-988-6004
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Fax | 800-988-6004
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Provider Business Mailing Address
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Address Line | 13207 HUNTERS LARK ST
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City | SAN ANTONIO
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State | TX
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Zip | 78230-2017
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Country | US
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Telephone | 800-988-6004
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Fax | 800-988-6004
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | ERLINDA BELVIS
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Credential | MD
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Telephone | 800-988-6004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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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 | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number |
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License Number State |
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