Provider Demographics
NPI:1528568961
Name:PLY, WESLEY (DC)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:
Last Name:PLY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 ARROW HL
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-2198
Mailing Address - Country:US
Mailing Address - Phone:512-667-0898
Mailing Address - Fax:
Practice Address - Street 1:2115 STEPHENS PL STE 700
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2162
Practice Address - Country:US
Practice Address - Phone:512-667-0898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-12
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13685111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition