Organization
LYMPHEDEMA & WOUNDCARE INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN C CHUSTON (CEO)
(832) 236-7926
Entity
Organization
Contact information
Practice address
10023 MAIN ST STE C8, HOUSTON, TX 77025-5252
(713) 526-7926
(281) 786-1966
Mailing address
PO BOX 20306, HOUSTON, TX 77225-0306
(713) 526-7926
(281) 786-1966
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5803665
CIGNA
TX
01
—
8CQ775
BC/BS
TX
Enumeration date
01/26/2007
Last updated
09/28/2020
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