Individual
WALESKA MIKAR GONTSCHARENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
8900 RED BLUFF RD APT 2633, PASADENA, TX 77507-1152
(917) 514-3296
Mailing address
8900 RED BLUFF RD APT 2633, PASADENA, TX 77507-1152
(917) 514-3296
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
21-113
TX
Other
Enumeration date
03/28/2021
Last updated
03/28/2021
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