Organization
LA IDEAL WOUND INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI PIERSANTI (OPERATIONS MANAGER)
(877) 969-6863
Entity
Organization
Contact information
Practice address
201 VICTORY BLVD, SUITE 287, MONROE, TX 71203
(877) 969-6863
Mailing address
1810 8TH AVE STE A101, FORT WORTH, TX 76110-1352
(877) 969-6863
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/12/2025
Last updated
08/12/2025
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