| Philip R. Wisiackas, M.d., P.a. | |
|
110 Hill Ave Coldspring TX 77331-5406 | |
| (936) 653-4223 | |
| (936) 653-5042 |
| Full Name | Philip R. Wisiackas, M.d., P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 110 Hill Ave, Coldspring, Texas |
| Authorized Official Name and Position | Philip Robert Wisiackas (PHYSICIAN) |
| Authorized Official Contact | 9366534223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Philip R. Wisiackas, M.d., P.a. 110 Hill Ave Coldspring TX 77331-5406 Ph: (936) 653-4223 | Philip R. Wisiackas, M.d., P.a. 110 Hill Ave Coldspring TX 77331-5406 Ph: (936) 653-4223 |
| NPI Number | 1174838411 |
|---|---|
| Provider Enumeration Date | 08/11/2010 |
| Last Update Date | 04/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174838411 | NPI | - | NPPES |
| 00FS32 | Other | TX | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | F4703 (Texas) | Primary |
Huntsville Memorial Med Clinic - Coldspring Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 Hill Ave, Coldspring, TX 77331 Phone: 936-439-1450 | |
Providence Family Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 21 Alpine St, Coldspring, TX 77331 Phone: 936-647-2227 Fax: 936-647-2202 |