Organization
WACO BONE & JOINT CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF L WISE (ADMINISTRATOR)
(254) 754-0375
Entity
Organization
Contact information
Practice address
5100 FRANKLIN AVEUNE, SUITE C, WACO, TX 76710-6922
(254) 754-0375
(254) 754-2667
Mailing address
5100 FRANKLIN AVEUNE, SUITE C, WACO, TX 76710-6922
(254) 754-0375
(254) 754-2667
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0833246-02
—
TX
Enumeration date
06/04/2007
Last updated
08/31/2015
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