First Source Wound Care

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

FIRST SOURCE WOUND CARE

Practice address

1540 Keller Pkwy Ste 108-168
Keller, TX 76248-3686

Phone

(469) 850-3114

NPI assigned

Mar 13, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Peter Brokish, MDNPI 1053519645

Title

Vice-President

Phone

(469) 850-3114

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Peter A. Brokish, M.D.

  • Emergency Medicine Physician
  • Dallas, TX
  • NPI 1053519645
  NPD Authorized official

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1316705361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 KELLER PKWY STE 108-168",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483686",
            "telephone_number": "469-850-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 KELLER PKWY STE 108-168",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483686",
            "telephone_number": "469-850-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST SOURCE WOUND CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-12",
        "status": "A",
        "authorized_official_last_name": "BROKISH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "469-850-3114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Fetter
• Harrison Scott Field, DDS
• Stacy McCrary Fincher, LCSW
• Firm Foundation Wellness Center
• First Keller Healthcare, LLC
• Fleming Vision Care LLC
• Jennifer Toepperwein Fleming, LPC
• Zoe Fleming
• Judith Virginia Flesher
• Hailey Flores

• Home Health Agency in Keller, TX
• Providers in Keller, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.