Individual provider Active NPI

David Matthew Wynne, M.D.

  • Vascular & Interventional Radiology Physician
  • Houston, TX
National Provider Identifier
1962722702
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
P2175 Issued in TX
Practice address
1504 Taub Loop
Houston, TX 77030-1608
Phone
(713) 873-2412
NPI assigned
Jun 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 390200000X TX
Vascular & Interventional Radiology Physician 2085R0204X 60192680 WA
Vascular & Interventional Radiology Physician 2085R0204X P2175 TX Primary

Addresses

Primary practice location

1504 Taub Loop
Houston, TX 77030-1608

Mailing address

1 Baylor PLZ
Houston, TX 77030-3411
Phone (713) 798-4438

Other practice location 1

1959 NE Pacific St
University of Washington Medical Center
Seattle, WA 98195-0001
Phone (206) 543-5972

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120605000523 TX Practitioner - Diagnostic RadiologyPractitioner - Pathology 8527222439 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Pathology
Education
University of Texas Southwestern Medical School at Dallas, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baylor College of MedicineGroup PAC ID 8224941265, 796 clinicians

Practice addresses (Care Compare)

1504 Taub Loop
Houston, TX 77030-1608
Phone (713) 873-2000

Hospital & facility affiliations

  • Harris Health Hospital, Houston, TX, CCN 450289

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
390200000XTXMDOphthalmology Physician
60192680WAMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Singleton Associates PA Diagnostic Radiology CurrentSince Mar 1, 2018 Accepting new patients
Baylor College of Medicine CurrentSince Jan 1, 2014 Accepting new patients
Baylor College of Medicine Diagnostic Radiology CurrentSince Jan 1, 2014 Accepting new patients
Baylor College of Medicine Past Accepting new patients
Baylor College of Medicine Diagnostic Radiology Past Accepting new patients

Locations

1110 N Sarah Dewitt Dr
Gonzales, TX 78629
Phone (830) 672-3845

1504 Taub Loop
#621
Houston, TX 77030

2525 Holly Hall St
#A
Houston, TX 77054
Phone (713) 526-4243

2457 S Braeswood Blvd
Houston, TX 77030
Phone (713) 520-8860

7200 Cambridge St
Fl 1
Houston, TX 77030
Phone (713) 798-3924

6620 Main St
Ste 1275
Houston, TX 77030
Phone (713) 798-2300

1504 Taub Loop
Houston, TX 77030
Phone (713) 873-2860

6720 Bertner Ave
#270
Houston, TX 77030
Phone (832) 355-4092

2 Greenway Plz
Ste 900
Houston, TX 77046
Phone (713) 798-1835

4600 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 853-9302

1 Baylor Plz
Va Hospital, TX 77030
Phone (713) 798-5588

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749772800000",
    "number": "1962722702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAYLOR PLZ",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770303411",
            "telephone_number": "713-798-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 TAUB LOOP",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770301608",
            "telephone_number": "713-873-2412"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE Pacific St",
            "address_2": "University of Washington Medical Center",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-543-5972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYNNE",
        "first_name": "DAVID",
        "middle_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-03",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "390200000X",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WA",
            "license": "60192680",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "P2175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.