Healthcare Provider Details

I. General information

NPI: 1760430458
Provider Name (Legal Business Name): ROBERTO WAYHS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 03/23/2022
Certification Date: 03/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3430 W WHEATLAND RD STE 202
DALLAS TX
75237-3447
US

IV. Provider business mailing address

3430 W. WHEATLAND ROAD POB I SUITE 202
DALLAS TX
75237-3446
US

V. Phone/Fax

Practice location:
  • Phone: 972-283-1800
  • Fax: 972-283-1801
Mailing address:
  • Phone: 972-283-1800
  • Fax: 972-283-1801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberK1722
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberK1722
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberK1722
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: