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Individual

DR. BLAKE ELDEN WAYMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6901 HELEN OF TROY DRIVE, BLDG C, EL PASO, TX 79911-3043
(915) 581-8090
Mailing address
6024 UPPER VALLEY RD, EL PASO, TX 79932-4305

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
12342
TX

Other

Enumeration date
08/31/2006
Last updated
08/15/2012
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