| Full Spectrum Wound Care Alliance | |
|
540 I 45 N Ste. B Huntsville TX 77320 | |
| (936) 295-1777 | |
| (936) 295-3680 |
| Full Name | Full Spectrum Wound Care Alliance |
|---|---|
| Speciality | Internal Medicine |
| Location | 540 I 45 N, Huntsville, Texas |
| Authorized Official Name and Position | Justin Hogan (OWNER) |
| Authorized Official Contact | 9362951777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Spectrum Wound Care Alliance 5524 Brady Bayou Cv The Hills TX 78738-1535 Ph: (936) 295-1777 | Full Spectrum Wound Care Alliance 540 I 45 N Ste. B Huntsville TX 77320 Ph: (936) 295-1777 |
| NPI Number | 1144950486 |
|---|---|
| Provider Enumeration Date | 06/10/2022 |
| Last Update Date | 06/10/2022 |
| Medicare PECOS PAC ID | 8325423486 |
|---|---|
| Medicare Enrollment ID | O20220910000356 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144950486 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| Provider Name | Lawrence H Nguyen |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1750350567 PECOS PAC ID: 5698719706 Enrollment ID: I20050618000172 |
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