MR. Wildon Mellinger Rouse III

NPI #1003873845 in La Grange, Texas

Provider Information

NPI Number: 1003873845
Entity Type: Individual
Name: MR. Wildon Mellinger Rouse III
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Apr 26, 2006
Last Updated: Dec 4, 2013

Practice Location

Address: 1253 N VON MINDEN ST
City: La Grange
State: Texas
ZIP Code: 78945-1262
Phone: (979) 968-8493

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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