| Lsa Wound Care, PLLC | |
|
4617 94th St Lubbock TX 79424-5015 | |
| (512) 965-4557 | |
| Not Available |
| Full Name | Lsa Wound Care, PLLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 4617 94th St, Lubbock, Texas |
| Authorized Official Name and Position | Garry Mcintosh (BUSINESS MANAGER) |
| Authorized Official Contact | 5129654557 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lsa Wound Care, PLLC 4617 94th St Lubbock TX 79424-5015 | Lsa Wound Care, PLLC 4617 94th St Lubbock TX 79424-5015 Ph: (512) 965-4557 |
| NPI Number | 1366337610 |
|---|---|
| Provider Enumeration Date | 06/09/2025 |
| Last Update Date | 08/19/2025 |
| Certification Date | 08/19/2025 |
| Medicare PECOS PAC ID | 4183111990 |
|---|---|
| Medicare Enrollment ID | O20251015002358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366337610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| Provider Name | Lindsey Mireles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396260733 PECOS PAC ID: 0345513602 Enrollment ID: I20170907002927 |
| Provider Name | Alan Pang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205281623 PECOS PAC ID: 4284018482 Enrollment ID: I20220908000098 |
| Provider Name | Joshua Aston Reyes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861110892 PECOS PAC ID: 6406380583 Enrollment ID: I20241112002778 |
| Provider Name | Madison K Thomas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134716905 PECOS PAC ID: 7517371578 Enrollment ID: I20260110000102 |
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