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Individual

DON WAYNE BERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
624 RIO GRAND LOOP, GEORGETOWN, TX 78633
(806) 789-6136
Mailing address
624 RIO GRAND LOOP, GEORGETOWN, TX 78633
(806) 789-6136

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
D4602
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
P00CB758
TX
Enumeration date
09/25/2009
Last updated
09/25/2009
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