| Waco Wound Care, PLLC | |
|
1300 Lake Air Dr Ste 7 Waco TX 76710-4452 | |
| (254) 744-5877 | |
| Not Available |
| Full Name | Waco Wound Care, PLLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1300 Lake Air Dr Ste 7, Waco, Texas |
| Authorized Official Name and Position | Jennifer Slover (OFFICE MANAGER) |
| Authorized Official Contact | 2547445877 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waco Wound Care, PLLC 1300 Lake Air Dr Ste 7 Waco TX 76710-4452 | Waco Wound Care, PLLC 1300 Lake Air Dr Ste 7 Waco TX 76710-4452 Ph: (254) 744-5877 |
| NPI Number | 1548057425 |
|---|---|
| Provider Enumeration Date | 04/23/2025 |
| Last Update Date | 04/23/2025 |
| Certification Date | 04/23/2025 |
| Medicare PECOS PAC ID | 5395251110 |
|---|---|
| Medicare Enrollment ID | O20250718003575 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548057425 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Mina L Ledoux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821555335 PECOS PAC ID: 2961742960 Enrollment ID: I20190328000987 |
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