Organization Active NPI

Wound Integrity PC

  • Internal Medicine Physician
  • Snellville, GA
National Provider Identifier
1861869141
Registry record updated Aug 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
74705 Issued in GA
Legal business name
WOUND INTEGRITY PC
Practice address
2295 Ronald Reagan Pkwy
Snellville, GA 30078-5654
Phone
(770) 982-2331
Fax
(770) 972-4104
NPI assigned
Aug 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2015

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

Authorized official

Name
Dr. Han Ngoc Pham, M.D.
Title
Ceo
Phone
(214) 274-1507

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 74705 GA Primary

Addresses

Primary practice location

2295 Ronald Reagan Pkwy
Snellville, GA 30078-5654

Mailing address

100 Crescent CT Ste 700
Dallas, TX 75201-2112
Phone (512) 202-3830

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1440115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440115200000",
    "number": "1861869141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CRESCENT CT STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752012112",
            "telephone_number": "512-202-3830",
            "fax_number": "512-354-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 RONALD REAGAN PKWY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785654",
            "telephone_number": "770-982-2331",
            "fax_number": "770-972-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOUND INTEGRITY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-21",
        "last_updated": "2015-08-21",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "HAN",
        "authorized_official_middle_name": "NGOC",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-274-1507",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "74705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; 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.