Provider Demographics
NPI:1669237111
Name:PERMIAN BASIN WOUND CARE SPECIALISTS, PLLC
Entity type:Organization
Organization Name:PERMIAN BASIN WOUND CARE SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BURROWS
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:817-614-6867
Mailing Address - Street 1:4311 ANDREWS HWY STE W
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-4823
Mailing Address - Country:US
Mailing Address - Phone:817-614-6867
Mailing Address - Fax:432-400-4419
Practice Address - Street 1:4311 ANDREWS HWY STE W
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-4823
Practice Address - Country:US
Practice Address - Phone:817-614-6867
Practice Address - Fax:432-400-4419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Single Specialty