Provider Demographics
NPI:1265442198
Name:WOUND CARE INNOVATIONS, LLC
Entity Type:Organization
Organization Name:WOUND CARE INNOVATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-265-7244
Mailing Address - Street 1:5452 GLEN LAKES DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4338
Mailing Address - Country:US
Mailing Address - Phone:214-265-7244
Mailing Address - Fax:214-265-7245
Practice Address - Street 1:5452 GLEN LAKES DR
Practice Address - Street 2:SUITE 201
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4338
Practice Address - Country:US
Practice Address - Phone:214-265-7244
Practice Address - Fax:214-265-7245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4877900001Medicare ID - Type Unspecified