Organization
INNOVATIONS WOUND MANAGEMENT, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MOIRA HAYES MHA, RRT, CHT (PRACTICE ADMINISTRATOR)
(713) 301-5707
Entity
Organization
Contact information
Practice address
1234 WAGNER ST, HOUSTON, TX 77007-3719
(713) 868-3301
(713) 868-4817
Mailing address
1234 WAGNER ST, HOUSTON, TX 77007-3719
(713) 868-3301
(713) 868-4817
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
E8768
TX
208D00000X
General Practice Physician
M1782
TX
208D00000X
General Practice Physician
Primary
N6545
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A4031
PTAN
TX
01
—
0A4645
PTAN
TX
01
—
0A5999
PTAN
TX
05
—
2083529-01
—
TX
01
—
TXB101103
PTAN
TX
Enumeration date
04/07/2009
Last updated
10/27/2010
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