THIRD EYE WOUND CARE PLLC NPI 1770030587

NPI Information

NPI: 1770030587
Provider Name: THIRD EYE WOUND CARE, PLLC
Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
3437 W 7TH ST
FORT WORTH, TX
ZIP 76107
Phone: (817) 688-1588
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THIRD EYE WOUND CARE, PLLC is a geriatric medicine family medicine in Fort Worth, TX. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. THIRD EYE WOUND CARE, PLLC NPI is 1770030587. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3437 W 7TH ST
FORT WORTH, TX
ZIP 76107-718
Phone: (817) 688-1588
Fax: (817) 423-7361

The provider's authorized official is Mark Allen Sanders .
The authorized official title is President, Ceo and has the following contact phone number (817) 688-1588.

The enumeration date for this NPI number is 9/9/2016 and was last updated on 9/9/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QH0002X	Family Medicine	Hospice and Palliative Medicine	K9653	TEXAS	No
2	209800000X	Legal Medicine		K9653	TEXAS	No
3	207QG0300X	Family Medicine	Geriatric Medicine	K9653	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	314993	MEDICARE PIN	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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