| Community Wound Resource, Llc | |
|
1600 S Henderson Blvd Kilgore TX 75662-3518 | |
| (903) 475-2713 | |
| (903) 942-2930 |
| Full Name | Community Wound Resource, Llc |
|---|---|
| Speciality | General Practice |
| Location | 1600 S Henderson Blvd, Kilgore, Texas |
| Authorized Official Name and Position | Dana Carter (MEMBER) |
| Authorized Official Contact | 8329677970 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Wound Resource, Llc 1600 S Henderson Blvd Kilgore TX 75662-3518 Ph: (903) 475-2713 | Community Wound Resource, Llc 1600 S Henderson Blvd Kilgore TX 75662-3518 Ph: (903) 475-2713 |
| NPI Number | 1851924625 |
|---|---|
| Provider Enumeration Date | 02/19/2020 |
| Last Update Date | 03/21/2024 |
| Medicare PECOS PAC ID | 2860831948 |
|---|---|
| Medicare Enrollment ID | O20240423000577 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851924625 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jeffrey G Mcwilliams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104037639 PECOS PAC ID: 9830242825 Enrollment ID: I20101004001231 |
| Provider Name | Jacquelyn B Hopkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134600919 PECOS PAC ID: 6204180854 Enrollment ID: I20181116001929 |
| Provider Name | Nicolette Silverio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942845243 PECOS PAC ID: 6709168149 Enrollment ID: I20200324002152 |
| Provider Name | Connie Sue Fiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326654724 PECOS PAC ID: 8527478692 Enrollment ID: I20201123001304 |
| Provider Name | Lay'c Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942856562 PECOS PAC ID: 3173934197 Enrollment ID: I20201124001149 |
| Provider Name | Tiffany Tyeskie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437803715 PECOS PAC ID: 4880089184 Enrollment ID: I20220324000041 |
| Provider Name | Emily Groce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629708946 PECOS PAC ID: 6305227687 Enrollment ID: I20220718002574 |
Carebridge Medteam, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 S Henderson Blvd, Kilgore, TX 75662 Phone: 903-475-3474 | |
Michael W. Mcshan, M.d., P.a. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1711 S Henderson Blvd, Suite 300, Kilgore, TX 75662 Phone: 903-983-1578 | |
Trinity Clinic Kilgore Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1718 S Henderson Blvd, Kilgore, TX 75662 Phone: 903-983-2110 Fax: 903-986-9148 | |
Qv Urgent Care Tx Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1016 N Kilgore St, Kilgore, TX 75662 Phone: 903-522-4199 | |
Trinity Clinic Kilgore 2 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 307 Woodlawn, Kilgore, TX 75662 Phone: 903-983-2110 | |
Wellness Pointe Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1711 S. Henderson Blvd., Ste. 400, Kilgore, TX 75662 Phone: 903-758-2610 Fax: 903-758-3124 |