Look up the most recent NPI and PECOS records

Texas Advanced Wound Care, Pllc

Internal Medicine

Allopathic & Osteopathic Physicians

4001 W 15th St, Suite 100, Plano, TX 75093-5841

PECOS Enrollment

Based on the most recent information from CMS, provider Texas Advanced Wound Care, Pllc does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1770805640
Provider Type
Organization
Full Name
Texas Advanced Wound Care, Pllc

Subpart
No
Enumeration Date
2/19/2010
Last Updated
2/5/2014

Contact Information

Practice Location

4001 W 15th St, Suite 100, Plano, TX 75093-5841

(214) 473-7671

(214) 473-7680

Mailing Location

3308 Preston Rd, Suite 350, Pmb 133, Plano, TX 75093-7453

Unlisted Phone

Unlisted Fax

Authorized Official

Dinh, Marie Thi (Proprietor)

(214) 729-9912

Provider Taxonomies

Code	Description	License
Code 207R00000X Primary	Description Internal Medicine Allopathic & Osteopathic Physicians	License M6107 Texas

Provider Identifiers

ID	Description	Issuer
ID TXB109820	Description Other	Issuer PTAN

Texas Advanced Wound Care, Pllc

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Dallas Medical Physician Group

Tobolowsky, Paul Arthur

North Dallas Patieint Care Pa

Son N Giep M D P A

Aman, Ayesha Aslam

Mohiuddin, Asim

Care2you Llc

Bricker, Eric Randolph

Schrader, Michael Keith

Naureen I. Agha, M.D. Pllc