Organization
OB-GYN ASSOCIATES OF WACO, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOEL MARK RISTER M.D. (DOCTOR COOWNER)
(254) 752-4395
Entity
Organization
Contact information
Practice address
2501 AMBASSADOR DR, WACO, TX 76712-0000
(254) 752-4395
(254) 752-7343
Mailing address
2501 AMBASSADOR DR, WACO, TX 76712-0000
(254) 752-4395
(254) 752-7343
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
G3732
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
097556702
—
TX
05
—
099097002
—
TX
Enumeration date
02/13/2009
Last updated
02/13/2009
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