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General NPI Number Information
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NPI Number | 1407844350
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Entity Type | Individual
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Provider Name | WEERACHAI WIRI MD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 07/16/2007
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Provider Practice Location Address
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Address Line | 116 JOHN DUPRE DR
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City | LEVELLAND
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State | TX
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Zip | 79336-6300
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Country | US
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Telephone | 806-894-1514
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Fax |
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Provider Business Mailing Address
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Address Line | 116 JOHN DUPRE DR
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City | LEVELLAND
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State | TX
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Zip | 79336-6300
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Country | US
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Telephone |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G1804
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License Number State | TX
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