Provider Demographics
NPI:1134255201
Name:GERWIG, WAYSON DOWNS (DDS)
Entity type:Individual
Prefix:DR
First Name:WAYSON
Middle Name:DOWNS
Last Name:GERWIG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4425 98TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424
Mailing Address - Country:US
Mailing Address - Phone:806-794-7479
Mailing Address - Fax:806-783-8843
Practice Address - Street 1:4425 98TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424
Practice Address - Country:US
Practice Address - Phone:806-794-7479
Practice Address - Fax:806-783-8843
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX145051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice