Provider Demographics
NPI:1629683602
Name:RENOVO WOUND AND HYPERBARICS PLLC
Entity Type:Organization
Organization Name:RENOVO WOUND AND HYPERBARICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CODING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TWYLLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-675-7266
Mailing Address - Street 1:PO BOX 842861
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-2861
Mailing Address - Country:US
Mailing Address - Phone:972-675-7266
Mailing Address - Fax:972-607-4655
Practice Address - Street 1:401 N VALLEY PKWY STE 380
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3472
Practice Address - Country:US
Practice Address - Phone:469-904-6428
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-15
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty