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General NPI Number Information
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NPI Number | 1821855701
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Entity Type | Organization
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Legal Business Name | TEXAS WOUND ASSOCIATES, PLLC
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Dates
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Enumeration Date | 03/06/2024
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Last Update Date | 03/06/2024
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Provider Practice Location Address
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Address Line | 2323 ALLEN ST
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City | DALLAS
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State | TX
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Zip | 75204-2609
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Country | US
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Telephone | 512-640-5111
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Fax | 512-640-5115
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Provider Business Mailing Address
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Address Line | 2323 ALLEN ST
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City | DALLAS
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State | TX
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Zip | 75204-2609
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Country | US
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Telephone | 512-640-5111
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Fax | 512-640-5115
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Authorized Official
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Title or Position | MANAGER, ADMINISTRATOR
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Name | KEVEN MARSHALL PEARCE
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Credential |
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Telephone | 214-232-9870
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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