Provider Demographics
NPI:1467349522
Name:ELITE WOUND CARE MD, LLC
Entity type:Organization
Organization Name:ELITE WOUND CARE MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:HUA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-788-8737
Mailing Address - Street 1:10602 FOUNTAIN CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1375
Mailing Address - Country:US
Mailing Address - Phone:347-788-8737
Mailing Address - Fax:
Practice Address - Street 1:2023 N MASON RD STE 203
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-3779
Practice Address - Country:US
Practice Address - Phone:347-788-8737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-20
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty