Philip Robert Wisiackas, MD is a medicare enrolled "Family Medicine" physician in Coldspring, Texas. His current practice location is
110 Hill Ave, Coldspring, Texas. You can reach out to his office (for appointments etc.) via phone at
(936) 653-4223.
Philip Robert Wisiackas is licensed to practice in Texas (license number F4703) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. 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 | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1568454304
- Provider Enumeration Date: 08/18/2005
- Last Update Date: 06/11/2012
Medicare PECOS Information:
- PECOS PAC ID: 7810024338
- Enrollment ID: I20240808003939
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
enrolled with medicare and thus, if eligible, can 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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