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Individual

DR. JOHN S DRYDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5500 KELL, SUITE 200, WICHITA FALLS, TX 76310-1612
(940) 689-8765
(940) 689-8769
Mailing address
5500 KELL BLVD, SUITE 200, WICHITA FALLS, TX 76310-1612
(940) 689-8765
(940) 689-8769

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
E8446
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0243510001
MEDICARE DME, PALMETTO
TX
05
103595803
TX
01
8AT661
BLUE CROSS & BLUE SHIELD
TX
01
P00474272
RAILROAD MEDICARE
TX
Enumeration date
01/06/2006
Last updated
06/10/2008
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