Organization
WYRICK DERMATOLOGY ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT W WYRICK M.D. (PRESIDENT)
(903) 792-3787
Entity
Organization
Contact information
Practice address
3333 POTOMAC AVE, TEXARKANA, TX 75503-3513
(903) 792-3787
(903) 792-0446
Mailing address
3333 POTOMAC AVE, TEXARKANA, TX 75503-3513
(903) 792-3787
(903) 792-0446
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109371802
—
TX
05
—
145002002
—
AR
Enumeration date
07/26/2005
Last updated
04/09/2013
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