Provider Demographics
NPI:1134463540
Name:WCS PROFESSIONAL SERVICES OF TEXAS, LLC
Entity Type:Organization
Organization Name:WCS PROFESSIONAL SERVICES OF TEXAS, LLC
Other - Org Name:WOUND CARE SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-835-4919
Mailing Address - Street 1:3445 N CAUSEWAY BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-3734
Mailing Address - Country:US
Mailing Address - Phone:504-835-4919
Mailing Address - Fax:866-237-2017
Practice Address - Street 1:3017 N CAUSEWAY BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-7682
Practice Address - Country:US
Practice Address - Phone:504-835-4919
Practice Address - Fax:866-237-2017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty