Provider Demographics
NPI:1104644228
Name:COMPLEX WOUND SOLUTIONS, LLC
Entity type:Organization
Organization Name:COMPLEX WOUND SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LONNETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-733-0038
Mailing Address - Street 1:610 CROWNPOINT LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4776
Mailing Address - Country:US
Mailing Address - Phone:469-733-0038
Mailing Address - Fax:
Practice Address - Street 1:5830 E 2ND ST STE 7000
Practice Address - Street 2:#18531
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-4308
Practice Address - Country:US
Practice Address - Phone:469-733-0038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty