Provider Demographics
NPI:1467964767
Name:CHRONIC WOUND SOLUTIONS OF TEXAS LLC
Entity Type:Organization
Organization Name:CHRONIC WOUND SOLUTIONS OF TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:210-245-6436
Mailing Address - Street 1:1603 BABCOCK RD STE 238
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4741
Mailing Address - Country:US
Mailing Address - Phone:210-245-6436
Mailing Address - Fax:210-783-9210
Practice Address - Street 1:1603 BABCOCK RD STE 238
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4741
Practice Address - Country:US
Practice Address - Phone:210-245-6436
Practice Address - Fax:210-783-9210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-26
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies