Provider Demographics
NPI:1609017755
Name:WOUND PROFESSIONAL SERVICES OF HOUSTON, P.A.
Entity Type:Organization
Organization Name:WOUND PROFESSIONAL SERVICES OF HOUSTON, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VP OF SALES AND MARKETING
Authorized Official - Prefix:MS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:E
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-409-8223
Mailing Address - Street 1:13317 WESTBURY WAY
Mailing Address - Street 2:
Mailing Address - City:GOSHEN
Mailing Address - State:KY
Mailing Address - Zip Code:40026-8422
Mailing Address - Country:US
Mailing Address - Phone:502-409-8223
Mailing Address - Fax:502-409-8330
Practice Address - Street 1:5822 JUNIPER KNOLL LN
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77345-1928
Practice Address - Country:US
Practice Address - Phone:502-409-8223
Practice Address - Fax:502-409-8330
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WOUND PROFESSIONALS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center