Organization Active NPI

North Texas Mobile Wound Care, LLC

  • Nurse Practitioner
  • Grand Prairie, TX
National Provider Identifier
1023815214
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
NORTH TEXAS MOBILE WOUND CARE, LLC
Practice address
2952 Montalbo
Grand Prairie, TX 75054-6506
Phone
(817) 915-6053
NPI assigned
Feb 26, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dematria Holbrook, DNP, APRN, FNP-CNPI 1053669010
Title
Ceo/ Founder
Phone
(817) 915-6053

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QG0300X
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

2952 Montalbo
Grand Prairie, TX 75054-6506

Mailing address

2952 Montalbo
Grand Prairie, TX 75054-6506
Phone (817) 915-6053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250521003731 TX Part B Supplier - Clinic/Group Practice 5395264402 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Prairie, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1023815214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2952 MONTALBO",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750546506",
            "telephone_number": "817-915-6053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2952 MONTALBO",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750546506",
            "telephone_number": "817-915-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH TEXAS MOBILE WOUND CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "HOLBROOK",
        "authorized_official_first_name": "DEMATRIA",
        "authorized_official_title_or_position": "CEO/ FOUNDER",
        "authorized_official_telephone_number": "817-915-6053",
        "authorized_official_credential": "DNP, APRN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.