Basic Information
| Provider Information | |||||||||
| NPI: | 1497083315 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WOUND HEALING ASSOCIATES PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2935 THOUSAND OAKS | ||||||||
| Address2: | SUITE 294 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782473312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104941100 | ||||||||
| FaxNumber: | 2104941117 | ||||||||
| Practice Location | |||||||||
| Address1: | 1305 WONDER WORLD DR | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | SAN MARCOS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786667546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105925349 | ||||||||
| FaxNumber: | 2105923462 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2009 | ||||||||
| LastUpdateDate: | 06/06/2011 | ||||||||
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| AuthorizedOfficialLastName: | ROBBINS | ||||||||
| AuthorizedOfficialFirstName: | MARK | ||||||||
| AuthorizedOfficialMiddleName: | PHILLIP | ||||||||
| AuthorizedOfficialTitleorPosition: | CO-OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2104218372 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | D.O. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083P0011X | H2721 | TX | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Preventive Medicine | Undersea and Hyperbaric Medicine |
No ID Information.