Active NPI
Bob K. Wynn, M.D. P.a.
- Family Medicine Physician
- Buna, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- F2723
- Legal business name
- BOB K. WYNN, M.D. P.A.
- Practice address
- 296 US Highway Business 96
Buna, TX 77612-0437 - Phone
- (409) 994-2427
- Fax
- (409) 994-3132
- NPI assigned
- Dec 21, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Bob K. Wynn, M.D.
- Title
- Owner
- Phone
- (409) 994-2427
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | F2723 | TX | Primary |
Addresses
Primary practice location
296 US Highway Business 96
Buna, TX 77612-0437
Mailing address
PO Box 1270
Buna, TX 77612-1270
Phone (409) 994-2427
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112088301 | Medicaid | TX | |
| 00HL63 | Other | TX | MEDICARE |
National Provider Directory
National Provider DirectoryLocations
296 US Highway Business 96
Buna, TX 77612
Phone (409) 651-4150
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Medicine Physician
- Buna, TX
- NPI 1487611091
-
- Family Nurse Practitioner
- Buna, TX
- NPI 1194843359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261353600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1261353600000",
"number": "1356670335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1270",
"city": "BUNA",
"state": "TX",
"postal_code": "776121270",
"telephone_number": "409-994-2427",
"fax_number": "409-994-3132"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "296 US HIGHWAY BUSINESS 96",
"city": "BUNA",
"state": "TX",
"postal_code": "776120437",
"telephone_number": "409-994-2427",
"fax_number": "409-994-3132"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BOB K. WYNN, M.D. P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2009-12-21",
"last_updated": "2009-12-21",
"status": "A",
"authorized_official_last_name": "WYNN",
"authorized_official_first_name": "BOB",
"authorized_official_middle_name": "K.",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "409-994-2427",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "TX",
"license": "F2723",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112088301",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "00HL63",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Buna, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.