Provider Demographics
NPI:1710631676
Name:DYNAMIC WOUND CARE
Entity Type:Organization
Organization Name:DYNAMIC WOUND CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ERLINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELVIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-988-6004
Mailing Address - Street 1:13207 HUNTERS LARK ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2017
Mailing Address - Country:US
Mailing Address - Phone:800-988-6004
Mailing Address - Fax:800-988-6004
Practice Address - Street 1:13207 HUNTERS LARK ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2017
Practice Address - Country:US
Practice Address - Phone:800-988-6004
Practice Address - Fax:800-988-6004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-09
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult HealthGroup - Single Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty