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NPI Code Detail

MEDICARE: CHRISTOPHER RYAN WYATT MD

MEDICARE: CHRISTOPHER RYAN WYATT 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
1207P00000XEmergency Medicine Physician57012005OH
2207P00000XEmergency Medicine PhysicianR8291TX

General Provider Information

NPI Number : 1578776100
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER RYAN WYATT MD
Provider Business Mailing Address
First Line : 18227 HEWETSON CV
Second Line :
City : AUSTIN
State : TX
Zip : 78738-2133
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1500 RED RIVER ST
Second Line :
City : AUSTIN
State : TX
Zip : 78701-1918
Country : US
Telephone Number : 512-324-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2007
Last Update Date : 05/07/2021

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Directions to “ CHRISTOPHER RYAN WYATT MD” Practice Location

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