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General NPI Number Information
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NPI Number | 1437405875
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Entity Type | Organization
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Legal Business Name | WESLEY T. MYERS, MD PA
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Dates
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Enumeration Date | 08/02/2012
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 100 MEDICAL CENTER BLVD STE 213
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City | CONROE
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State | TX
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Zip | 77304
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Country | US
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Telephone | 936-539-8115
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Fax | 936-539-8118
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Provider Business Mailing Address
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Address Line | 100 MEDICAL CENTER BLVD SUITE 213
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City | CONROE
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State | TX
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Zip | 77304
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Country | US
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Telephone | 936-539-8115
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Fax | 936-539-8118
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Authorized Official
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Title or Position | OWNER
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Name | DR. WESLEY THOMAS MYERS
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Credential | MD
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Telephone | 936-539-8115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | M4387
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | M4387
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License Number State | TX
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