Individual
RALPH T WYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1845 PRECINCT LINE RD STE 209, HURST, TX 76054-3109
(817) 632-5803
(817) 632-5803
Mailing address
1845 PRECINCT LINE RD STE 209, HURST, TX 76054-3109
(817) 632-5803
(817) 632-5803
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
234251
NY
2085R0202X
Diagnostic Radiology Physician
Primary
G3923
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G3923
TEXAS MEDICAL BOARD
TX
Enumeration date
12/29/2005
Last updated
11/19/2020
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