Organization Active NPI

Wesley T. Myers, MD PA

  • Plastic and Reconstructive Surgery Physician
  • Conroe, TX
National Provider Identifier
1437405875
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
M4387 Issued in TX
Legal business name
WESLEY T. MYERS, MD PA
Practice address
100 Medical Center Blvd
Ste 213
Conroe, TX 77304
Phone
(936) 539-8115
Fax
(936) 539-8118
NPI assigned
Aug 2, 2012
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Wesley Thomas Myers, MDNPI 1497959076
Title
Owner
Phone
(936) 539-8115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X M4387 TX
Plastic and Reconstructive Surgery Physician 2086S0122X M4387 TX Primary

Addresses

Primary practice location

100 Medical Center Blvd
Ste 213
Conroe, TX 77304

Mailing address

100 Medical Center Blvd
Suite 213
Conroe, TX 77304
Phone (936) 539-8115

Other identifiers 2

IdentifierTypeStateIssuer
10149037OtherDPS
M4387OtherLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120925000199 TX Part B Supplier - Clinic/Group Practice 6103074794 Receives reassigned benefits from 1 practitioner
Practice locations: Conroe, TX

National Provider Directory

National Provider Directory

Locations

100 Medical Center Blvd
#T
Conroe, TX 77304

100 Medical Center Blvd
Ste 2
Conroe, TX 77304

100 Medical Center Blvd
Ste 213
Conroe, TX 77304
Phone (936) 539-8115

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1437405875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER BLVD",
            "address_2": "SUITE 213",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "77304",
            "telephone_number": "936-539-8115",
            "fax_number": "936-539-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MEDICAL CENTER BLVD",
            "address_2": "STE 213",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "77304",
            "telephone_number": "936-539-8115",
            "fax_number": "936-539-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY T. MYERS, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-02",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-539-8115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "M4387",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "M4387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DPS",
            "identifier": "10149037",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "M4387",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.