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WICKWIRE, BRIAN MACY       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: NUESTRA CLINICA DEL VALLE
801 WEST FIRST STREET
SAN JUAN TX 78589

Address last updated on 7/3/2016
Phone #: (956) 787-8915
Fax #:
County: NOT OKLAHOMA
License: 18190
Dated: 7/20/1992
Expires: 7/1/2017
License Type: Medical Doctor
Specialty: Internal Medicine
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: YES
Medical School: VANDERBILT UNIV SCH OF MED, NASHVILLE TN 37232
Graduated: 5 / 1989
CME Year: 2018
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF INTERNAL MEDICINE
New Patients: Yes
Medicaid: Yes
Medicare: Yes
   
HMO/PPO: None listed
Hospital Privileges: Hospital(s) Not In Oklahoma
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Locations: Hours: Languages:
NUESTRA CLINICA DEL VALLE
801 WEST FIRST STREET
SAN JUAN TX 78589

Phone #: (956) 787-8915
Fax #:
Mon: 8:00AM - 5:00PM
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:
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