Provider Demographics
NPI:1457470528
Name:JONES, WAYNE C (MD)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:C
Last Name:JONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:375 MUNICIPAL DR STE 224
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3624
Mailing Address - Country:US
Mailing Address - Phone:972-234-0489
Mailing Address - Fax:972-235-1558
Practice Address - Street 1:375 MUNICIPAL DR STE 224
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3624
Practice Address - Country:US
Practice Address - Phone:972-234-0489
Practice Address - Fax:972-235-1558
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD60492084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC17621Medicare UPIN