Provider Demographics
NPI:1982814463
Name:WYSINGER, DAVID HOWARD (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:HOWARD
Last Name:WYSINGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1123 BROOK RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-2707
Mailing Address - Country:US
Mailing Address - Phone:972-743-4242
Mailing Address - Fax:
Practice Address - Street 1:5001 MCKINNEY RANCH PKWY STE A
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-8601
Practice Address - Country:US
Practice Address - Phone:972-743-4242
Practice Address - Fax:972-547-4202
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6856T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist