Provider Demographics
NPI:1780985390
Name:WOUND & OSTOMY CARE SERVICES OF SOUTH TEXAS, INC
Entity type:Organization
Organization Name:WOUND & OSTOMY CARE SERVICES OF SOUTH TEXAS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JAVIER
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, BC, CNS, MSN
Authorized Official - Phone:956-240-2394
Mailing Address - Street 1:2701 KELLIE DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-4707
Mailing Address - Country:US
Mailing Address - Phone:956-240-2394
Mailing Address - Fax:
Practice Address - Street 1:3519 W ALBERTA RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8466
Practice Address - Country:US
Practice Address - Phone:956-240-2394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2021-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601952364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-SurgicalGroup - Single Specialty