Doctor Name: | DALE A WOOTEN |
NPI Number: | 1043595465 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CCP |
License Number: | |
Business Practice Address: | 312 E Houston St Tyler, TX - 757028218 |
Business Phone Number: | 4807770607 |
Business Fax Number: | 4807771345 |
Mailing Address: | Po Box 27664, TEMPE |
State: | AZ |
Postal Code: | 852857664 |
Phone Number: | 4807770607 |
Fax Number: | 4807771345 |
NPI Enumeration Date: | 10/17/2011 |
NPI Last Update Date: | 10/17/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 242T00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Perfusionist |
Taxonomy Specialization: | |
Taxonomy Definition: | A perfusionist operates extracorporeal circulation and autotransfusion equipment during any medical situation where it is necessary to support or temporarily replace the patient |