Wyrick Dermatology Association

LBN: Wyrick Dermatology Association
Wyrick Dermatology Association is an health care organization with primary practice located at 3333 Potomac Ave , Texarkana TX 75503-3513. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Wyrick Dermatology Association can be contacted via phone (903) 792-3787, or through Wyrick, Scott W via phone (903) 792-3787.

Contact Information

Primary practice address
3333 Potomac Ave Texarkana TX 75503-3513
Phone: (903) 792-3787
Fax: (903) 792-0446
Website:
Map and Directions
Authorized official contact:
Name: Wyrick, Scott W Doctor of Medicine (MD)
Phone: (903) 792-3787

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1619977295
LBN Legal business name Wyrick Dermatology Association
DBA Doing business as
Authorized official Wyrick, Scott W Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 26th, 2005
Last updated Apr 9th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619977295 NPPES
Texas MEDICAID 109371802
Texas MEDICAID 145002002

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