Provider Demographics
NPI:1073860342
Name:HAWK'S NEST GERIATRICS & WOUND CARE, LLC
Entity type:Organization
Organization Name:HAWK'S NEST GERIATRICS & WOUND CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:HOWERY
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:ADVANCE PRACTICE NUR
Authorized Official - Phone:281-387-6916
Mailing Address - Street 1:PO BOX 681085
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77268-1085
Mailing Address - Country:US
Mailing Address - Phone:281-387-6916
Mailing Address - Fax:
Practice Address - Street 1:4000 FULTON ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77009-4766
Practice Address - Country:US
Practice Address - Phone:713-695-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center