NPIMap

Organization Active NPI

Innovations Wound Management, PA

  • General Practice Physician
  • Houston, TX
National Provider Identifier
1083857049
Registry record updated Oct 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
N6545 Issued in TX
Legal business name
INNOVATIONS WOUND MANAGEMENT, PA
Practice address
1234 Wagner St
Houston, TX 77007-3719
Phone
(713) 868-3301
Fax
(713) 868-4817
NPI assigned
Apr 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2010

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

Authorized official

Name
Ms. Moira Hayes, MHA, RRT, CHT
Title
Practice Administrator
Phone
(713) 301-5707

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X E8768 TX
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X M1782 TX
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X N6545 TX Primary

Addresses

Primary practice location

1234 Wagner St
Houston, TX 77007-3719

Mailing address

1234 Wagner St
Houston, TX 77007-3719
Phone (713) 868-3301

Other identifiers 5

IdentifierTypeStateIssuer
0A5999OtherTXPTAN
2083529-01MedicaidTX
0A4645OtherTXPTAN
0A4031OtherTXPTAN
TXB101103OtherTXPTAN

National Provider Directory

National Provider Directory

Locations

11001 Crescent Moon Dr
Houston, TX 77064
Phone (281) 319-4060

4650 S Panther Creek Dr
#D
The Woodlands, TX 77381
Phone (281) 363-3535

Practitioners & affiliated clinicians

Practitioners 9

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": "1239062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288137600000",
    "number": "1083857049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 WAGNER ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770073719",
            "telephone_number": "713-868-3301",
            "fax_number": "713-868-4817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 WAGNER ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770073719",
            "telephone_number": "713-868-3301",
            "fax_number": "713-868-4817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIONS WOUND MANAGEMENT, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-07",
        "last_updated": "2010-10-27",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "MOIRA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "713-301-5707",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MHA, RRT, CHT"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "E8768",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "M1782",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "N6545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0A5999",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2083529-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0A4645",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "0A4031",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "TXB101103",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.