Individual
CHARLES CLIFTON WYKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
4460 BISSONNET ST STE 200, BELLAIRE, TX 77401-3218
(713) 524-3434
(713) 524-3220
Mailing address
4460 BISSONNET ST STE 200, BELLAIRE, TX 77401-3218
(713) 524-3434
(713) 524-3220
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
N9336
TX
207WX0107X
Retina Specialist (Ophthalmology) Physician
N9336
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
282988901
—
TX
01
—
TXB127953
MEDICARE ID
TX
Enumeration date
05/22/2007
Last updated
01/11/2022
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