WYRICK DERMATOLOGY ASSOCIATION (NPI# 1619977295) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619977295 |
| Entity Type | Organization |
| Organization Name | WYRICK DERMATOLOGY ASSOCIATION |
| Practice Address |
3333 Potomac Ave Texarkana TX 75503-3513 |
| Practice Telephone | 9037923787 |
| Practice Fax Number | 9037920446 |
| Mailing Telephone | 9037923787 |
| Mailing Fax Number | 9037920446 |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2013-04-09 |
| Authorized Official Name | SCOTT W WYRICK (PRESIDENT) |
| Authorized Official Telephone | 9037923787 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 145002002 | 05 | |
| TX | 109371802 | 05 |
| Street Address |
3333 POTOMAC AVE |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503-3513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114920972 | Scott W Wyrick | Family Medicine | 3333 Potomac Ave, Texarkana, TX 75503-3513 | 2005-05-24 |
| 1942232087 | Lenore P Wyrick | Nurse Practitioner | 3333 Potomac Ave, Texarkana, TX 75503-3513 | 2006-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699287094 | Dennis D Obanion Md | Clinic/Center | 1801 Galleria Oaks Dr, Texarkana, TX 75503-4616 | 2017-10-26 |
| 1184242059 | Living Well Chiropractic PC | Clinic/Center | 4211 Texas Blvd, Texarkana, TX 75503-3012 | 2020-07-08 |
| 1669990990 | Border City Chiropractic | Clinic/Center | 2905 Genoa Rd, Texarkana, AR 71854-9358 | 2017-09-07 |
| 1306194519 | Southern Sky Vision Center | Clinic/Center | 2901 Richmond Rd, Texarkana, TX 75503-2125 | 2012-08-17 |
| 1871575514 | Collom and Carney Clinic Association | Clinic/Center | 5002 Cowhorn Creek Rd, Texarkana, TX 75503-9766 | 2005-11-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.