Bob K Wynn, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

F2723 Issued in TX

Practice address

296 US Hwy Business 96
Pob 1270
Buna, TX 77612-1270

Phone

(409) 994-2427

Fax

(409) 994-3132

NPI assigned

Apr 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hyden Health Care, PLLC

  • Family Nurse Practitioner
  • Buna, TX
  • NPI 1508297334
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261526400000",
    "number": "1487611091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1270",
            "address_2": "296 US HWY BUSINESS 96",
            "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 HWY BUSINESS 96",
            "address_2": "POB 1270",
            "city": "BUNA",
            "state": "TX",
            "postal_code": "776121270",
            "telephone_number": "409-994-2427",
            "fax_number": "409-994-3132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "BOB",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2009-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F2723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112088301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darby Reed, LPA
• Ceaetta Harris Renfro
• Resilient Minds PLLC
• Sovereign T Farm
• Paula Renee Tacker, LMSW
• Harris Achidi Yango, PHARMD

• Family Medicine Physician in Buna, TX
• Providers in Buna, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.

Verify at the official NPI Registry.