Provider Demographics
NPI:1972533982
Name:WOUNDKAIR CONCEPTS, INC
Entity type:Organization
Organization Name:WOUNDKAIR CONCEPTS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-968-6352
Mailing Address - Street 1:7535 BENBROOK PARKWAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BENBROOK
Mailing Address - State:TX
Mailing Address - Zip Code:76126-9700
Mailing Address - Country:US
Mailing Address - Phone:866-968-6352
Mailing Address - Fax:866-968-6353
Practice Address - Street 1:7535 BENBROOK PARKWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-9700
Practice Address - Country:US
Practice Address - Phone:866-968-6352
Practice Address - Fax:866-968-6353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1756918-02Medicaid
TX1756918-02Medicaid