Dale A Wooten JR., CCP

NPI #1043595465 in Tyler, Texas

Provider Information

NPI Number: 1043595465
Entity Type: Individual
Name: Dale A Wooten JR., CCP
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Perfusionist
Credential: CCP
Enumeration Date: Oct 17, 2011
Last Updated: Oct 17, 2011

Practice Location

Address: 312 E HOUSTON ST
City: Tyler
State: Texas
ZIP Code: 75702-8218
Phone: (480) 777-0607

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Perfusionist	242T00000X	Primary

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