Provider Demographics
NPI:1245931401
Name:WOUND SOLUTIONS OF TEXAS LLC
Entity type:Organization
Organization Name:WOUND SOLUTIONS OF TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-422-8172
Mailing Address - Street 1:1169 N BURLESON BLVD STE 107 #302
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-8458
Mailing Address - Country:US
Mailing Address - Phone:214-422-8172
Mailing Address - Fax:
Practice Address - Street 1:13988 DIPLOMAT DR STE 100C
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-8807
Practice Address - Country:US
Practice Address - Phone:214-422-8172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty