NPIMap

Organization Active NPI

San Antonio Wound Care LLC

Doing business as San Antonio Wound Care

  • Clinic/Center
  • Live Oak, TX
National Provider Identifier
1619502929
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SAN ANTONIO WOUND CARE LLC
Doing business as
San Antonio Wound Care
Practice address
12501 Judson Rd Ste 102
Live Oak, TX 78233-4117
Phone
(210) 369-9151
NPI assigned
Mar 6, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Authorized official

Name
Clifford Crossett
Title
President
Phone
(832) 274-6455

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0011X
Clinic/Center 261Q00000X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

12501 Judson Rd Ste 102
Live Oak, TX 78233-4117

Mailing address

12501 Judson Rd Ste 102
Live Oak, TX 78233-4117

Other names 1

  • San Antonio Wound Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1583452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1619502929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12501 JUDSON RD STE 102",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782334117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 JUDSON RD STE 102",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "782334117",
            "telephone_number": "210-369-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-06",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "CROSSETT",
        "authorized_official_first_name": "CLIFFORD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-274-6455"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Antonio Wound Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Live Oak, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.