Wray, Justin Wylie

Wray, Justin Wylie is an sole proprietor health care provider with primary practice located at 1700 West Ave # 6 , Waco TX 76707-3054. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Radiation Oncology. Allopathic & Osteopathic Physicians / Radiation Oncology is his primary health care specialty. Wray, Justin Wylie can be contacted via phone (254) 399-0741.

Contact Information

Primary practice address
1700 West Ave # 6 Waco TX 76707-3054
Phone: (254) 399-0741
Fax: (254) 399-0779
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X TRN17315 Florida
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X R3455 Texas

Profile Details

NPI number 1407116163
LBN Legal business name Wray, Justin Wylie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 29th, 2012
Last updated Jun 20th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407116163 NPPES
Texas MEDICAID 372654902
Texas MEDICAID 372654901

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