Individual
DR. BOB K WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
296 US HWY BUSINESS 96, POB 1270, BUNA, TX 77612-1270
(409) 994-2427
(409) 994-3132
Mailing address
PO BOX 1270, 296 US HWY BUSINESS 96, BUNA, TX 77612-1270
(409) 994-2427
(409) 994-3132
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F2723
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112088301
—
TX
Enumeration date
04/27/2006
Last updated
12/23/2009
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