Organization
REVIVE WOUND CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHANNES NEUENDORF DO (OWNER)
(760) 809-8654
Entity
Organization
Contact information
Practice address
28496 RANCH ROAD 12, STE 200 # 105, DRIPPING SPRINGS, TX 78620
(951) 760-6216
Mailing address
13423 BLANCO RD UNIT 3255, SAN ANTONIO, TX 78216-2187
(951) 760-6216
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
251E00000X
Home Health Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/02/2024
Last updated
10/02/2024
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