MEDICARE: DFW WOUND CARE

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
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1215333067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DFW WOUND CARE

Provider Business Mailing Address
First Line	:	5600 W LOVERS LN
Second Line	:	116-312
City	:	DALLAS
State	:	TX
Zip	:	75209-4330
Country	:	US
Telephone Number	:	469-277-2701
Fax Number	:	469-277-2703

Provider Business Practice Location Address
First Line	:	17051 DALLAS PKWY STE 250
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-7121
Country	:	US
Telephone Number	:	469-277-2701
Fax Number	:	469-277-2703

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SHANNON B PAYSEUR
Credential	:	MD
Telephone Number	:	469-277-2701

Provider Enumeration Date	:	11/06/2014
Last Update Date	:	02/12/2020

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Directions to “DFW WOUND CARE ” Practice Location

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