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Individual
SCOTT W WYRICK
Active
Individual
SCOTT W WYRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J2424
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070016709
MEDICARE RAILROAD
TX
05
—
148032001
—
AR
05
—
150168601
—
TX
01
—
80451Y
BLUE CROSS
TX
01
—
8312J1
MEDICARE
TX
01
—
99096
BLUE CROSS
AR
01
—
T0120358
CONTROLLED SUBSTANCES REG
TX
Enumeration date
05/24/2005
Last updated
09/02/2026
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