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Individual

DR. KEVIN LEN WACASEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6400 COLLEYVILLE BLVD, COLLEYVILLE, TX 76034-6444
(817) 416-6111
(866) 929-9602
Mailing address
6400 COLLEYVILLE BLVD, COLLEYVILLE, TX 76034-6444
(817) 416-6111
(866) 929-9602

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
K3519
TX
208D00000X
General Practice Physician
Primary
K3519
TX

Other

Enumeration date
07/19/2006
Last updated
02/18/2016
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