Wacker, Douglass John

Wacker, Douglass John is an individual health care provider with primary practice located at 3900 La Branch St , Houston TX 77004-4046. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist is his primary health care specialty. Wacker, Douglass John can be contacted via phone (713) 524-3949.

Contact Information

Primary practice address
3900 La Branch St Houston TX 77004-4046
Phone: (713) 524-3949
Fax: (713) 524-3915
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist 224P00000X 85 Texas
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist 222Z00000X 85 Texas

Profile Details

NPI number 1790927192
LBN Legal business name Wacker, Douglass John
Credentials C.P.O.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2009
Last updated Nov 30th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790927192 NPPES
Texas MEDICAID PO0012

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