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Individual

ASHLEY R WYATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6515 TIDWELL RD STE D, HOUSTON, TX 77016-4842
(832) 248-4727
Mailing address
1801 SMITH ST STE 1905, HOUSTON, TX 77002-8192
(832) 248-4727

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
TX

Other

Enumeration date
07/22/2024
Last updated
07/22/2024
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