Provider Demographics
NPI:1194536243
Name:MEDICUS WOUND CARE PLLC
Entity type:Organization
Organization Name:MEDICUS WOUND CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN NOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LARROZA
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:773-946-6068
Mailing Address - Street 1:5625 CYPRESS CREEK PKWY STE 504
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4212
Mailing Address - Country:US
Mailing Address - Phone:888-711-6114
Mailing Address - Fax:888-711-6114
Practice Address - Street 1:5625 CYPRESS CREEK PKWY STE 504
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4212
Practice Address - Country:US
Practice Address - Phone:888-711-6114
Practice Address - Fax:888-711-6114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty