Healthcare Provider Details

I. General information

NPI: 1952467367
Provider Name (Legal Business Name): WESLEY A MAYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1327 LAKE POINTE PKWY STE 305
SUGAR LAND TX
77478-4394
US

IV. Provider business mailing address

6560 FANNIN ST SUITE 2100
HOUSTON TX
77030-2761
US

V. Phone/Fax

Practice location:
  • Phone: 171-379-8352
  • Fax:
Mailing address:
  • Phone: 713-441-6455
  • Fax: 713-790-4456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMT186259
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberN6487
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: