Bryon Keith Wade Jr.

Peer Specialist · Pryor, OK

Individual Active NPI

NPI number 1104794973

Practice location

109 N Fairland St
Pryor, OK 74361-4205
Phone
(918) 625-6128

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NPI record

NPI
1104794973
Entity type
Individual (Type 1)
Enumeration date
October 24, 2025
Last updated
October 24, 2025
Certified
October 24, 2025
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Peer Specialist Primary 175T00000X — OK

About Bryon Wade

Bryon Keith Wade Jr. is a healthcare provider registered in the NPI registry with the primary taxonomy Peer Specialist (code 175T00000X). The practice location is 109 N Fairland St, Pryor, OK 74361-4205. The NPI number 1104794973 was assigned on October 24, 2025 and the record was last updated on October 24, 2025.

Frequently asked questions

What is the NPI number of Bryon Keith Wade Jr.?

The NPI number is 1104794973.

What is the phone number of Bryon Wade?

The phone number listed for the practice location is (918) 625-6128.

Where is Bryon Wade located?

109 N Fairland St, Pryor, OK 74361-4205.

What is the taxonomy code for Bryon Wade?

The primary taxonomy code is 175T00000X – Peer Specialist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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