1013933605 NPI number — LYMPHEDEMA & WOUND CARE CONSULTANTS OF AMERICA, INC.

Table of content: (NPI 1013933605)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013933605 NPI number — LYMPHEDEMA & WOUND CARE CONSULTANTS OF AMERICA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LYMPHEDEMA & WOUND CARE CONSULTANTS OF AMERICA, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013933605
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 58598
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEBSTER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77598-8598
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-338-2590
Provider Business Mailing Address Fax Number:
281-338-2594

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16888 HIGHWAY 3
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEBSTER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77598-2112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-338-2590
Provider Business Practice Location Address Fax Number:
281-338-2594
Provider Enumeration Date:
07/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HAMILTON
Authorized Official First Name:
ERIN
Authorized Official Middle Name:
K
Authorized Official Title or Position:
PRESIDENT, CEO
Authorized Official Telephone Number:
281-338-2590

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X , with the licence number: 0083862 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1013933605 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: DE3913 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0057MY . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 8L13479 . This is a "MCR PTAN-MOOSA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: TXB160448 . This is a "MCR PTAN-STREITMANN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1265420053 . This is a "NPI-REILLY NIVERS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1386624450 . This is a "NPI-STREITMANN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 00666Z . This is a "MCR-GROUP PTAN" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1588874473 . This is a "NPI - NEIGHBORS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1982709010 . This is a "NPI - ADOLF" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 275757AR1K . This is a "MCR PTAN- REILLY NIVERS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1871555052 . This is a "NPI-MOOSA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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