Provider Demographics
NPI:1346741691
Name:SUTHERLAND WOUNDCARE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:SUTHERLAND WOUNDCARE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTHERLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-282-3330
Mailing Address - Street 1:3301 SHADOW WOOD CIR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75077-1802
Mailing Address - Country:US
Mailing Address - Phone:806-282-3330
Mailing Address - Fax:
Practice Address - Street 1:3301 SHADOW WOOD CIR
Practice Address - Street 2:
Practice Address - City:HIGHLAND VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:75077-1802
Practice Address - Country:US
Practice Address - Phone:806-282-3330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty