NPIMap

Organization Active NPI

Renovo Wound and Hyperbarics PLLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Lewisville, TX
National Provider Identifier
1629683602
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
Legal business name
RENOVO WOUND AND HYPERBARICS PLLC
Practice address
401 N Valley Pkwy Ste 380
Lewisville, TX 75067-3472
Phone
(469) 904-6428
NPI assigned
Sep 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Authorized official

Name
Twylla Alexander
Title
Coding Manager
Phone
(972) 675-7266

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0011X Primary

Addresses

Primary practice location

401 N Valley Pkwy Ste 380
Lewisville, TX 75067-3472

Mailing address

PO Box 842861
Dallas, TX 75284-2861
Phone (972) 675-7266

Other practice location 1

5668 Edwards Ranch Rd Ste 101
Fort Worth, TX 76109-4109
Phone (817) 764-1554

Other practice location 2

1001 W Arbrook Blvd Ste 161
Arlington, TX 76015-4222
Phone (817) 402-0952

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201027000401 TX Part B Supplier - Clinic/Group Practice 6002236379 Receives reassigned benefits from 4 practitioners
Practice locations: Arlington, TX; Lewisville, TX; Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

1001 W Arbrook Blvd
Arlington, TX 76015

1001 W Arbrook Blvd
Ste 161
Arlington, TX 76015
Phone (817) 402-0952

5668 Edwards Ranch Rd
Ft Worth, TX 76109
Phone (817) 536-9600

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654732800000",
    "number": "1629683602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842861",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752842861",
            "telephone_number": "972-675-7266",
            "fax_number": "972-607-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N VALLEY PKWY STE 380",
            "city": "LEWISVILLE",
            "state": "TX",
            "postal_code": "750673472",
            "telephone_number": "469-904-6428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5668 Edwards Ranch Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761094109",
            "country_code": "US",
            "telephone_number": "817-764-1554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 W Arbrook Blvd Ste 161",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760154222",
            "country_code": "US",
            "telephone_number": "817-402-0952",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RENOVO WOUND AND HYPERBARICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-15",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "TWYLLA",
        "authorized_official_title_or_position": "CODING MANAGER",
        "authorized_official_telephone_number": "972-675-7266"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.