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Individual

GARY L WOMACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1327 TROUP HWY, TYLER, TX 75701
(903) 606-4733
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
E9467
TX
207W00000X
Ophthalmology Physician
N5777
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
123703001
AR
05
135498706
TX
05
135498709
TX
01
820733
MEDICARE
TX
01
8LE706
BCBS
TX
Enumeration date
07/28/2005
Last updated
09/11/2019
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