Organization
PRISM WOUND SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER WOODS APRN (PROVIDER)
(214) 886-5020
Entity
Organization
Contact information
Practice address
6304 E 102ND ST, TULSA, OK 74137-7120
(214) 886-5020
Mailing address
6304 E 102ND ST, TULSA, OK 74137-7120
(214) 886-5020
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538871744
PECOS
OK
05
—
200815420A
—
OK
Enumeration date
12/19/2022
Last updated
06/13/2023
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