# KRIS H WUSTERHAUSEN DO PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437476538
- **Authorized official:** DR. KRIS H WUSTERHAUSEN D.O. (PHYSICIAN)
- **Authorized official phone:** (817) 845-8322

## Contact information

- **Practice address:** 747 S SUGARTREE DR, LIPAN, TX 76462-4328
- **Practice address phone:** (817) 845-8322
- **Mailing address:** 747 S SUGARTREE DR, LIPAN, TX 76462-4328
- **Mailing address phone:** (817) 845-8322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | K8703 | TX | Yes |

## Other

- **Enumeration date:** 04/28/2010
- **Last updated:** 04/28/2010