Provider Demographics
NPI:1750971669
Name:WOUNDCARE PARTNERS OF TEXAS
Entity type:Organization
Organization Name:WOUNDCARE PARTNERS OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAWTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-970-6817
Mailing Address - Street 1:2637 N WASHINGTON BLVD # 164
Mailing Address - Street 2:
Mailing Address - City:NORTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84414-2240
Mailing Address - Country:US
Mailing Address - Phone:214-970-6817
Mailing Address - Fax:844-803-4513
Practice Address - Street 1:7777 FOREST LN STE C239
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-7522
Practice Address - Country:US
Practice Address - Phone:214-970-6817
Practice Address - Fax:844-803-4513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty