Individual
DR. MICHAEL LOUIS WYMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3500 GASTON AVE, 3HOB NEONATOLOGY, DALLAS, TX 75246-2096
(214) 820-4012
(214) 820-7757
Mailing address
3500 GASTON AVE, 3HOB NEONATOLOGY, DALLAS, TX 75246-2096
(214) 820-4012
(214) 820-7757
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
J5952
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P088E3884
—
TX
Enumeration date
05/10/2006
Last updated
07/08/2007
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