MEDICARE: AMERICAN WOUND CARE PROS, LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1699462598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN WOUND CARE PROS, LLC

Provider Business Mailing Address
First Line	:	3113 S UNIVERSITY DR STE 303
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-5619
Country	:	US
Telephone Number	:	682-250-3149
Fax Number	:	817-353-2065

Provider Business Practice Location Address
First Line	:	3113 S UNIVERSITY DR STE 303
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76109-5619
Country	:	US
Telephone Number	:	682-250-3149
Fax Number	:	817-353-2065

Authorized Official
Title or Position	:	OWNER
Name	:	MR. GARRETT ROYCE ADAMS
Credential	:
Telephone Number	:	714-585-5456

Provider Enumeration Date	:	04/20/2023
Last Update Date	:	01/02/2024

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