MEDICARE: WOUND PROFESSIONAL SERVICES OF HOUSTON

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	208D00000X	General Practice Physician	G8104	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891936266
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WOUND PROFESSIONAL SERVICES OF HOUSTON

Provider Business Mailing Address
First Line	:	25000 PITKIN RD
Second Line	:	SUITE 280
City	:	THE WOODLANDS
State	:	TX
Zip	:	77386-2467
Country	:	US
Telephone Number	:	713-301-5707
Fax Number	:	713-295-2863

Provider Business Practice Location Address
First Line	:	25000 PITKIN RD
Second Line	:	SUITE 280
City	:	THE WOODLANDS
State	:	TX
Zip	:	77386-2467
Country	:	US
Telephone Number	:	713-301-5707
Fax Number	:	713-295-2863

Authorized Official
Title or Position	:	SENIOR PARTNER
Name	:	CAROLINE E FIFE
Credential	:	MD
Telephone Number	:	713-301-5707

Provider Enumeration Date	:	03/16/2009
Last Update Date	:	03/16/2009

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Directions to “WOUND PROFESSIONAL SERVICES OF HOUSTON ” Practice Location

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