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General NPI Number Information
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NPI Number | 1184660060
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Entity Type | Individual
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Provider Name | ADAM THOMAS WYBLE PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 12700 PARK CENTRAL DR SUITE 900
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City | DALLAS
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State | TX
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Zip | 75251-1500
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Country | US
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Telephone | 214-860-6038
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Fax |
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Provider Business Mailing Address
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Address Line | 2313 WESTHORPE DR
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City | MALABAR
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State | FL
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Zip | 32950-7002
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Country | US
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Telephone | 509-818-9505
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3882
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA031966
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0007967
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9107678
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA17898
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License Number State | TX
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10340
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-11230
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License Number State | NC
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Taxonomy #8
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10004923
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License Number State | WA
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Taxonomy #9
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110003178
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License Number State | VA
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Taxonomy #10
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 55872
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License Number State | CA
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