Dfw Wound Management Pllc | |
17051 Dallas Pkwy Ste 250 Addison TX 75001-7121 | |
(972) 685-7330 | |
(469) 666-1084 |
Full Name | Dfw Wound Management Pllc |
---|---|
Speciality | Family Medicine |
Location | 17051 Dallas Pkwy Ste 250, Addison, Texas |
Authorized Official Name and Position | Shannon B Payseur (OWNER) |
Authorized Official Contact | 4692772701 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Dfw Wound Management Pllc 5600 W Lovers Ln # 116-312 Dallas TX 75209-4330 Ph: (469) 277-2701 | Dfw Wound Management Pllc 17051 Dallas Pkwy Ste 250 Addison TX 75001-7121 Ph: (972) 685-7330 |
NPI Number | 1952538076 |
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Provider Enumeration Date | 06/16/2009 |
Last Update Date | 11/11/2021 |
Medicare PECOS PAC ID | 5496092231 |
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Medicare Enrollment ID | O20190131002921 |
Identifier | Type | State | Issuer |
---|---|---|---|
1952538076 | NPI | - | NPPES |
12529264 | Other | TX | CAQH PROVIDER # |
218958101 | Medicaid | TX |
Provider Name | Shannon B Payseur |
---|---|
Provider Type | Practitioner - Preventive Medicine |
Provider Identifiers | NPI Number: 1891869517 PECOS PAC ID: 1759458615 Enrollment ID: I20080919000055 |
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