Individual
DR. JUSTIN WAYDE VICKERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10861 183A TOLL RD STE 1200, LEANDER, TX 78641-1257
(512) 439-1009
(512) 439-1145
Mailing address
4700 SETON CENTER PKWY STE 115, AUSTIN, TX 78759-5753
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
V7311
TX
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
V7311
TX
Other
Enumeration date
04/24/2019
Last updated
08/01/2025
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