PHILIP A. WALLER, MD, PA
Osteopathic Medicine at Gulf Fwy, Houston, TX

License number
Texas J3933
Category
Osteopathic Medicine
Type
Rheumatology
Owner
Name: DR. PHILIP A WALLER MD, PA
Title: OWNER
Phone: (281) 481-8557
Address
Address
12553 Gulf Fwy, Houston, TX 77034
National Provider ID: 1639368277
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PHILIP A. WALLER, M.D., PA

12553 Gulf Fwy, Houston, TX 77034

Doing business as:
Philip A. Waller, M.D., PA
Registration:
Apr 13, 2000
State ID:
0082118903
Business type:
Professional Association
President , Director , Member:
Philip A. Waller (President , Director , Member)
Agent:
Philip A Waller,12553 Gulf Fwy, Houston, TX 77034 (Physical)
TIN:
32035994071

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