| Innovations Wound Management, Pa | |
|
1234 Wagner St Houston TX 77007-3719 | |
| (713) 868-3301 | |
| (713) 868-4817 |
| Full Name | Innovations Wound Management, Pa |
|---|---|
| Speciality | General Practice |
| Location | 1234 Wagner St, Houston, Texas |
| Authorized Official Name and Position | Moira Hayes (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 7133015707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovations Wound Management, Pa 1234 Wagner St Houston TX 77007-3719 Ph: (713) 868-3301 | Innovations Wound Management, Pa 1234 Wagner St Houston TX 77007-3719 Ph: (713) 868-3301 |
| NPI Number | 1083857049 |
|---|---|
| Provider Enumeration Date | 04/07/2009 |
| Last Update Date | 10/27/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083857049 | NPI | - | NPPES |
| 0A5999 | Other | TX | PTAN |
| 2083529-01 | Medicaid | TX | |
| 0A4645 | Other | TX | PTAN |
| 0A4031 | Other | TX | PTAN |
| TXB101103 | Other | TX | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | E8768 (Texas) | Secondary |
| 208D00000X | General Practice | M1782 (Texas) | Secondary |
| 208D00000X | General Practice | N6545 (Texas) | Primary |
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