Individual
WEERACHAI WIRI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
116 JOHN DUPRE DR, LEVELLAND, TX 79336-6300
(806) 894-1514
Mailing address
116 JOHN DUPRE DR, LEVELLAND, TX 79336-6300
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G1804
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00RP09
BLUE CROSS BLUE SHIELD
TX
01
—
121302
SUPERIOR HEALTH PLAN
TX
01
—
4668718
AETNA
—
01
—
MDG1804
WORKERS COMP
TX
Enumeration date
10/13/2005
Last updated
07/16/2007
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