PHILIP ROBERT WISIACKAS (NPI# 1568454304) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568454304 |
| Entity Type | Individual |
| Full Name | PHILIP ROBERT WISIACKAS |
| Credential | MD |
| Practice Address |
110 Hill Ave Coldspring TX 77331-5406 |
| Practice Telephone | 9366534223 |
| Practice Fax Number | 9366535042 |
| Mailing Telephone | 9366534223 |
| Mailing Fax Number | 9366535042 |
| Enumeration Date | 2005-08-18 |
| Last Update Date | 2012-06-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | F4703 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BLUE CROSS BLUE SHIELD | 00FS32 | 01 |
| TX | 133086201 | 05 |
| Street Address |
110 HILL AVE |
| City | COLDSPRING |
| State | TX |
| Zip Code | 77331-5406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003291915 | Walker County Hospital Corporation | Clinic/Center | 110 Hill Ave, Coldspring, TX 77331-5406 | 2015-07-22 |
| 1174838411 | Philip R. Wisiackas, M.d., P.a. | Family Medicine | 110 Hill Ave, Coldspring, TX 77331-5406 | 2010-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801410907 | Rayshell Lynnette Dean | Technician | 2275 Hwy 150, Coldspring, TX 77331 | 2020-06-04 |
| 1114165495 | Rayfield Wayne Jefferson Sr. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2330 Fm 222, Coldspring, TX 77331 | 2009-01-26 |
| 1760627806 | Alexandra Spigelmyer Elliott | Occupational Therapist | 61 Church St., Coldspring, TX 77331 | 2008-12-03 |
| 1053534248 | Senior Citizens of San Jacinto County | Voluntary or Charitable | 60 Butler Street, Coldspring, TX 77331 | 2007-04-10 |
| 1700911609 | Jeffery Hugh Anderson | Chiropractor | 123 Coldspring Square, Coldspring, TX 77331 | 2007-02-22 |
| 1285734624 | Brookshire Brothers Inc | Pharmacy | 14761 Hwy 150 West, Coldspring, TX 77331 | 2006-09-25 |
| 1962439919 | Brookshire Brothers Inc | Pharmacy | 15100 Hwy 150 W, Coldspring, TX 77331 | 2006-06-26 |
| 1932197068 | Bill Ralph Sykes Jr. | Chiropractor | 15140 Hwy 150 We, Coldsprings, TX 77331 | 2005-10-12 |
| 1316073273 | Coldspring-oakhurst Cisd | Local Education Agency (LEA) | 14210 Highway 150, Coldspring, TX 77331-0039 | 2007-02-26 |
| 1083728596 | Jeffrey C. Brown | Dentist | 15130 State Hwy 150 West, Coldspring, TX 77331-0547 | 2006-08-19 |
| Find all providers in zip 77331 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457369985 | Richard M Perry | Family Medicine | 21 Alpine St, Coldspring, TX 77331-8058 | 2006-08-03 |
| 1174838411 | Philip R. Wisiackas, M.d., P.a. | Family Medicine | 110 Hill Ave, Coldspring, TX 77331-5406 | 2010-08-11 |
| 1205848033 | Tri Minh Le | Family Medicine | 21 Alpine St, Coldspring, TX 77331-8058 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669073599 | Julie Suzanne Rodriguez | Family Medicine | 421 W Wadley Ave Ste B, Midland, TX 79705-5368 | 2020-11-06 |
| 1871194670 | Priscilla Tehrani | Family Medicine | 615 North Loop E Unit 100, Houston, TX 77022-5934 | 2020-11-06 |
| 1821699976 | Dr. G Medical Solutions | Family Medicine | 4840 W Panther Creek Dr Ste 211, The Woodlands, TX 77381-3542 | 2020-11-05 |
| 1124629522 | Jose Reynaldo Carcamo Jr. | Family Medicine | 18568 Texas 46, Suite 1001, Spring Branch, TX 78070 | 2020-11-03 |
| 1205437662 | Angela Ekern | Family Medicine | 7421 Cordoba Dr, Austin, TX 78724-6252 | 2020-11-03 |
| 1770184020 | Kara Fenceroy | Family Medicine | 5425 Rolling Meadows Dr, Fort Worth, TX 76123-2836 | 2020-11-03 |
| 1881295327 | Courtney L Buchmeier | Family Medicine | 16620 San Pedro Ave, San Antonio, TX 78232-2327 | 2020-11-02 |
| 1003416207 | Adeline Galvez | Family Medicine | 1300 W Terrell Ave Ste 270, Fort Worth, TX 76104-2820 | 2020-10-27 |
| 1710585229 | Megan Alyse Loyd | Family Medicine | 2101 Kingsley Dr Apt 3106, Pearland, TX 77584-4118 | 2020-10-16 |
| 1104424795 | Rachel Elizabeth Whitten | Family Medicine | 614 S Business Ih 35 Ste A, New Braunfels, TX 78130-4748 | 2020-10-15 |
| Find all providers with the same taxonomy | ||||
| City | COLDSPRING |
| Zip Code | 77331 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.