Individual
JERRY K MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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
01
—
081928184
MEDICARE RAILROAD
TX
05
—
110622103
—
TX
01
—
81720X
BCBS
TX
Enumeration date
07/07/2005
Last updated
12/19/2013
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