Provider Demographics
NPI:1053411934
Name:WYRICK, LINDA CHRISTINE (PH D)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:CHRISTINE
Last Name:WYRICK
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HERRY CT
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5531
Mailing Address - Country:US
Mailing Address - Phone:830-708-3886
Mailing Address - Fax:
Practice Address - Street 1:7201 BROADWAY ST
Practice Address - Street 2:SUITE 218
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-3743
Practice Address - Country:US
Practice Address - Phone:830-708-3886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1786103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical