Organization Active NPI

Lsa Wound Care, PLLC

  • Multi-Specialty Clinic/Center
  • Lubbock, TX
National Provider Identifier
1366337610
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
LSA WOUND CARE, PLLC
Practice address
4617 94TH St
Lubbock, TX 79424-5015
Phone
(512) 965-4557
NPI assigned
Jun 9, 2025
Last updated
Aug 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Authorized official

Name
Garry McIntosh
Title
Business Manager
Phone
(512) 965-4557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

4617 94TH St
Lubbock, TX 79424-5015

Mailing address

4617 94TH St
Lubbock, TX 79424-5015

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251015002358 TX Part B Supplier - Clinic/Group Practice 4183111990 Receives reassigned benefits from 4 practitioners
Practice locations: Lubbock, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1366337610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4617 94TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794245015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4617 94TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794245015",
            "telephone_number": "512-965-4557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LSA WOUND CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "MCINTOSH",
        "authorized_official_first_name": "GARRY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "512-965-4557"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.