Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | BP10043544 | TX |
N | 111NI0900X | Internist | BP10043544 | TX |
Y | 207RC0000X | Internist - Cardiovascular Disease | E12014 | AR |
NPI | 1013276187 |
---|---|
Provider Name | Dr. Wesley Garrett Lane |
First Address | Temple, TX 76502-7916 |
Second Address | Little Rock, AR 72211-3886 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2012 |
Last Update Date | 21/08/2019 |