Individual
JACOB JOHN WINGERTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4900 MUELLER BLVD STE 3S.066C, AUSTIN, TX 78723-3079
(406) 868-9735
Mailing address
4900 MUELLER BLVD STE 3S.066C, AUSTIN, TX 78723-3079
(406) 868-9735
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
BP1-0039540
TX
Other
Enumeration date
04/26/2011
Last updated
04/26/2011
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