Organization
JERRY K. MYERS, M.D., ASSOCIATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA R BILLINGSLEY (OFFICE MANAGER)
(940) 696-5335
Entity
Organization
Contact information
Practice address
5500 KELL BLVD, SUITE 100, WICHITA FALLS, TX 76310-1612
(940) 696-5335
(940) 696-1114
Mailing address
5500 KELL BLVD, SUITE 100, WICHITA FALLS, TX 76310-1612
(940) 696-5335
(940) 696-1114
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E2757
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110622103
—
TX
01
—
81720X
BLUE CROSS BLUE SHIELD
TX
01
—
DO6534
RAILROAD MEDICARE
TX
Enumeration date
09/25/2006
Last updated
07/27/2009
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