Individual
DORI LYN WASMUNDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
125 W PARK AVE, HEREFORD, TX 79045-4201
(806) 364-7688
(806) 364-7694
Mailing address
2801 W 8TH ST, PLAINVIEW, TX 79072-6737
(806) 293-8561
(806) 293-8413
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03407
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191407901
—
TX
Enumeration date
07/29/2005
Last updated
04/01/2020
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