Provider Demographics
NPI:1700628294
Name:CR MOBILE WOUND CARE LLC
Entity type:Organization
Organization Name:CR MOBILE WOUND CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ULOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIAKWELU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-423-4472
Mailing Address - Street 1:6575 WEST LOOP S STE 500
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3509
Mailing Address - Country:US
Mailing Address - Phone:713-487-5233
Mailing Address - Fax:713-513-5311
Practice Address - Street 1:6575 WEST LOOP S STE 500
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3509
Practice Address - Country:US
Practice Address - Phone:713-487-5233
Practice Address - Fax:713-513-5311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty