Baker, Brent Wyatt

Baker, Brent Wyatt is an individual health care provider with primary practice located at 1410 W Jefferson St , Waxahachie TX 75165-2232. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Baker, Brent Wyatt can be contacted via phone (972) 937-1210.

Contact Information

Primary practice address
1410 W Jefferson St Waxahachie TX 75165-2232
Phone: (972) 937-1210
Fax: (972) 937-0243
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA04634 Texas

Profile Details

NPI number 1770774648
LBN Legal business name Baker, Brent Wyatt
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 6th, 2007
Last updated May 20th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770774648 NPPES
Texas MEDICAID 217344504

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