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General NPI Number Information
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NPI Number | 1932987864
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Entity Type | Organization
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Legal Business Name | GLOBAL OPEN WOUND CARE SERVICES LLC
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 01/26/2025
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Provider Practice Location Address
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Address Line | 11820 STANDING STONE DR
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City | GRETNA
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State | NE
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Zip | 68028-7979
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Country | US
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Telephone | 817-328-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 250 MIRON DR
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City | SOUTHLAKE
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State | TX
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Zip | 76092-7852
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Country | US
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Telephone | 817-328-3000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | GARY HOLLINGSWORTH
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Credential |
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Telephone | 817-328-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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