# ELIZABETH J WANNER, MD., PA

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

## Provider details

- **NPI number:** 1811261837
- **Authorized official:** DR. ELIZABETH JEAN WANNER MD., PA (PHYSICIAN/OWNER)
- **Authorized official phone:** (281) 351-1411

## Contact information

- **Practice address:** 1101 ALMA ST, STE 102, TOMBALL, TX 77375-4554
- **Practice address phone:** (281) 351-1411
- **Practice address fax:** (281) 351-0240
- **Mailing address:** 1101 ALMA ST, STE 102, TOMBALL, TX 77375-4554
- **Mailing address phone:** (281) 351-1411
- **Mailing address fax:** (281) 351-0240

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2012
- **Last updated:** 03/08/2012