Provider Demographics
NPI:1760982581
Name:WYNA, RILEY H (NP)
Entity Type:Individual
Prefix:MR
First Name:RILEY
Middle Name:H
Last Name:WYNA
Suffix:
Gender:M
Credentials:NP
Other - Prefix:MR
Other - First Name:RILEY
Other - Middle Name:HILCO
Other - Last Name:WYNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:3504 XENOPS AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4973
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 E SAVANNAH AVE STE 14
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1728
Practice Address - Country:US
Practice Address - Phone:956-668-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAPI136500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily