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Organization
TEXAS ADVANCED WOUND CARE GROUP
Active
Organization
TEXAS ADVANCED WOUND CARE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER AYODELE OTIKO MD (PRESIDENT)
(818) 836-2475
Entity
Organization
Contact information
Practice address
2400 AUGUSTA DR STE 369, HOUSTON, TX 77057-4911
(323) 545-4007
Mailing address
4640 ADMIRALTY WAY STE 500, MARINA DEL REY, CA 90292-6636
(818) 836-2475
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
04/25/2022
Last updated
04/25/2022
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