Providence Wound Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

PROVIDENCE WOUND CARE LLC

Practice address

9100 Southwest Fwy Ste 206
Houston, TX 77074-1531

Phone

(214) 315-5255

NPI assigned

Jun 13, 2024

Organization subpart

No

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

Authorized official

Name

Emmanuel Ositadinma Nwadeyi, DRPH, PA-CNPI 1992944821

Title

Ceo

Phone

(214) 315-5255

Specialties & licenses 1

Addresses

Practitioners 1

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

• Emmanuel Ositadinma Nwadeyi, PA-C

  • Physician Assistant
  • Rowlett, TX
  • NPI 1992944821
  NPD Authorized official

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

{
    "created_epoch": "1718236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1689417206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 HARWOOD DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774795165",
            "telephone_number": "214-315-5255",
            "fax_number": "346-571-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 SOUTHWEST FWY STE 206",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770741531",
            "telephone_number": "214-315-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE WOUND CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "NWADEYI",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_middle_name": "OSITADINMA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-315-5255",
        "authorized_official_credential": "DRPH, PA-C"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providian EMS (Providian EMS Inc)

• Internal Medicine Physician in Houston, TX
• Providers in Houston, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.