Individual
DR. JAMISON N WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
479 OXFORD DR STE 104, NEW BRAUNFELS, TX 78130-5479
(830) 214-0300
(830) 214-0397
Mailing address
479 OXFORD DR STE 104, NEW BRAUNFELS, TX 78130-7423
(830) 214-0300
(830) 214-0397
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
M9752
TX
207RC0000X
Cardiovascular Disease Physician
M9752
TX
207RI0011X
Interventional Cardiology Physician
Primary
M9752
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196568301
—
TX
05
—
196568302
—
TX
01
—
M9752
MEDICAL LICENSE
TX
Enumeration date
11/08/2007
Last updated
01/09/2024
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