MEDICARE: WESLEY DAY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	R1358	TX
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1437592813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WESLEY DAY MD

Provider Business Mailing Address
First Line	:	17440 DALLAS PKWY STE 228
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75287-7397
Country	:	US
Telephone Number	:	318-658-2225
Fax Number	:

Provider Business Practice Location Address
First Line	:	17440 DALLAS PKWY STE 228
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75287-7397
Country	:	US
Telephone Number	:	318-658-2225
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2013
Last Update Date	:	12/02/2020

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