Philip Robert Wisiackas, MD is a
Family Medicine physician based in Coldspring, Texas. Philip Robert Wisiackas is licensed to practice in Texas (license number F4703) and his current practice location is 110 Hill Ave, Coldspring, Texas. He can be reached at his office (for appointments etc.) via phone at
(936) 653-4223.
NPI number for Philip Robert Wisiackas is 1568454304 and his current mailing address is 110 Hill Ave, Coldspring, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1568454304.
Physician's Profile
| Full Name | Philip Robert Wisiackas |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 110 Hill Ave, Coldspring, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1568454304
- Provider Enumeration Date: 08/18/2005
- Last Update Date: 06/11/2012
Medical Identifiers
Medical identifiers for Philip Robert Wisiackas such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568454304 | NPI | - | NPPES |
| 00FS32 | Other | TX | BLUE CROSS BLUE SHIELD |
| 133086201 | Medicaid | TX | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | F4703 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Philip Robert Wisiackas is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Philip Robert Wisiackas, MD
110 Hill Ave,
Coldspring, TX 77331-5406
Ph: (936) 653-4223 | Philip Robert Wisiackas, MD
110 Hill Ave,
Coldspring, TX 77331-5406
Ph: (936) 653-4223 |
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