Philip R. Wisiackas, M.d., P.a.

NPI #1174838411 in Coldspring, Texas

Provider Information

NPI Number: 1174838411
Entity Type: Organization
Organization Name: Philip R. Wisiackas, M.d., P.a.
Primary Specialty: Family Medicine
Enumeration Date: Aug 11, 2010
Last Updated: Apr 7, 2011

Practice Location

Address: 110 HILL AVE
City: Coldspring
State: Texas
ZIP Code: 77331-5406
Phone: (936) 653-4223

Authorized Official

Name: PHILIP ROBERT WISIACKAS, MD
Title: PHYSICIAN
Phone: (936) 653-4223

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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