Organization
DFW WOUND MANAGEMENT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANNON B PAYSEUR MD (OWNER)
(469) 277-2701
Entity
Organization
Contact information
Practice address
17051 DALLAS PKWY STE 250, ADDISON, TX 75001-7121
(972) 685-7330
(469) 666-1084
Mailing address
5600 W LOVERS LN # 116-312, DALLAS, TX 75209-4330
(469) 277-2701
(469) 666-1084
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
M0858
TX
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12529264
CAQH PROVIDER #
TX
05
—
218958101
—
TX
Enumeration date
06/16/2009
Last updated
11/11/2021
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