| Wound Medic Llc | |
|
4408 Mesquite Terrace Dr Manvel TX 77578-1576 | |
| (702) 354-2920 | |
| Not Available |
| Full Name | Wound Medic Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4408 Mesquite Terrace Dr, Manvel, Texas |
| Authorized Official Name and Position | Marizel Yukee (OWNER) |
| Authorized Official Contact | 4076194931 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wound Medic Llc 4205 Broadway St Ste 221 Pearland TX 77581-4117 Ph: (346) 491-8168 | Wound Medic Llc 4408 Mesquite Terrace Dr Manvel TX 77578-1576 Ph: (702) 354-2920 |
| NPI Number | 1144971615 |
|---|---|
| Provider Enumeration Date | 01/15/2022 |
| Last Update Date | 10/17/2023 |
| Medicare PECOS PAC ID | 2668829789 |
|---|---|
| Medicare Enrollment ID | O20231111000696 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144971615 | NPI | - | NPPES |
| V68253 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
| Provider Name | Rahul Pandey |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1609051853 PECOS PAC ID: 8921185463 Enrollment ID: I20100327000558 |
| Provider Name | Jonathan B Garcellano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659955433 PECOS PAC ID: 9830595081 Enrollment ID: I20230426001906 |
Prestige Medical P A Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3945 County Road 58, Manvel, TX 77578 Phone: 281-412-6606 Fax: 281-489-0233 |