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GARRY WAYNE WICKLIFFE JR. LSA, CST
NPI 1336724236
Specialist/Technologist, Other - Surgical Assistant in Tyler, TX

Active since March 11, 2021
704 S FLEISHEL AVE, TYLER, TX 75701(903) 646-5350 Get Directions Write a Review

NPPES record last updated: March 31, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Garry Wayne Wickliffe Jr. Lsa, Cst NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GARRY WAYNE WICKLIFFE JR. LSA, CST (NPI 1336724236) is an individual surgical assistant in Tyler, Texas, licensed in Texas (SA00957) and active in the NPI registry since March 2021.

NPPES Registry Identity

NPI1336724236
Entity TypeIndividualMale
Primary Taxonomy246ZC0007X
Provider Legal NameGARRY WAYNE WICKLIFFE JR.Credential: LSA, CST
Location Address704 S FLEISHEL AVETyler, TX 75701-2014
Mailing Address2320 Kaynell DrHenderson, TX 75654-4718 · (936) 635-3169
Phone(903) 646-5350
Sole ProprietorNo
Enumeration DateMarch 11, 2021
Last NPPES UpdateMarch 31, 2024
NPPES CertifiedMarch 31, 2024
✔ NPI 1336724236 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialist/Technologist, Other · Surgical AssistantTechnologists, Technicians & Other Technical Service Providers
Taxonomy Code246ZC0007X
License✔ Licensed in TX · SA00957
Definition
A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training.
704 S FLEISHEL AVE, Tyler, TX 75701
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SURGICAL ASSOCIATES OF EAST TEXAS, LLP
Nurse Practitioner (Family)
704 S FLEISHEL AVE
TYLER, TX 75701
Smith County (903) 595-6680

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Garry Wickliffe's NPI number?

The NPI number for Garry Wickliffe is 1336724236. It was assigned to this individual provider in the NPPES registry on March 11, 2021.

Where is Garry Wickliffe located?

Garry Wickliffe practices at 704 S Fleishel Ave, Tyler, TX 75701. The listed phone number is (903) 646-5350.

What is Garry Wickliffe's specialty?

The primary specialty registered for this NPI is Specialist/Technologist, Other, specializing in Surgical Assistant, with taxonomy code 246ZC0007X.

What insurance does Garry Wickliffe accept?

Health plans from Blue Cross and Blue Shield of Texas list Garry Wickliffe as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Garry Wickliffe was last updated on March 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.