Provider Demographics
NPI:1821855701
Name:TEXAS WOUND ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:TEXAS WOUND ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER, ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVEN
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-232-9870
Mailing Address - Street 1:2323 ALLEN ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2609
Mailing Address - Country:US
Mailing Address - Phone:512-640-5111
Mailing Address - Fax:512-640-5115
Practice Address - Street 1:2323 ALLEN ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2609
Practice Address - Country:US
Practice Address - Phone:512-640-5111
Practice Address - Fax:512-640-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty