# BLC WOUND CARE PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508500638
- **Authorized official:** BRAD TAYLOR LANDRUM MD (OWNER)
- **Authorized official phone:** (817) 793-0513

## Contact information

- **Practice address:** 400 W LYNDON B JOHNSON FWY STE 130, IRVING, TX 75063-3700
- **Practice address phone:** (972) 990-5222
- **Practice address fax:** (972) 990-3900
- **Mailing address:** 9819 EDGECOVE DR, DALLAS, TX 75238-1535
- **Mailing address phone:** (817) 793-0513
- **Mailing address fax:** (972) 990-3900

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | NULL | Yes |
| 2083P0011X | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/25/2022
- **Last updated:** 09/15/2023