Provider Demographics
NPI:1528365830
Name:BELAIRE, WAYNE CHRISTOPHER (WAYNE BELAIRE)
Entity Type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:CHRISTOPHER
Last Name:BELAIRE
Suffix:
Gender:M
Credentials:WAYNE BELAIRE
Other - Prefix:MR
Other - First Name:WAYNE
Other - Middle Name:CHRISTOPHER
Other - Last Name:BELAIRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:WAYNE BELAIRE
Mailing Address - Street 1:3167 MARIANNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PORT NECHES
Mailing Address - State:TX
Mailing Address - Zip Code:77651-6015
Mailing Address - Country:US
Mailing Address - Phone:409-626-1866
Mailing Address - Fax:
Practice Address - Street 1:3167 MARIANNWOOD DR.
Practice Address - Street 2:
Practice Address - City:PORT NECHES
Practice Address - State:TX
Practice Address - Zip Code:77651-6015
Practice Address - Country:US
Practice Address - Phone:409-626-1866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-23
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX605997163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant