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NPI Code Detail

MEDICARE: WOUND PROS TEXAS

MEDICARE: WOUND PROS TEXAS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1073151700
Entity Type Code : Organization
Provider Name (Legal Business Name) : WOUND PROS TEXAS
Provider Business Mailing Address
First Line : 5901 W CENTURY BLVD STE 750
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-5443
Country : US
Telephone Number : 323-480-4075
Fax Number : 323-433-9177
Provider Business Practice Location Address
First Line : 2400 AUGUSTA DR STE 369
Second Line :
City : HOUSTON
State : TX
Zip : 77057-4911
Country : US
Telephone Number : 888-880-3451
Fax Number :
Authorized Official
Title or Position : OWNER
Name : CHRISTOPHER AYODELE OTIKO
Credential : MD
Telephone Number : 818-836-2475
Provider Enumeration Date : 12/12/2019
Last Update Date : 01/20/2023

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Directions to “WOUND PROS TEXAS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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