| NPI | 1437235116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP R WISIACKAS Physician 281-592-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX f4703) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2010-02-02 |