Provider Demographics
NPI:1225741937
Name:TOTAL WOUND CARE OF TEXAS LLC
Entity type:Organization
Organization Name:TOTAL WOUND CARE OF TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BURGESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-659-6993
Mailing Address - Street 1:1900 NW EXPRESSWAY STE 800
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-1804
Mailing Address - Country:US
Mailing Address - Phone:405-659-6993
Mailing Address - Fax:
Practice Address - Street 1:2150 S CENTRAL EXPY STE 200
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4000
Practice Address - Country:US
Practice Address - Phone:405-246-0810
Practice Address - Fax:405-546-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-28
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty