Organization
WISHING WELL CHILDREN'S CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSABELLE VIA MCCONKEY MD (PEDIATRICIAN)
(832) 856-4600
Entity
Organization
Contact information
Practice address
1259 FM 1463, SUITE 300, KATY, TX 77494
(832) 856-4600
Mailing address
1259 FM 1463, SUITE 300, KATY, TX 77494
(832) 856-4600
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Enumeration date
01/04/2019
Last updated
05/16/2024
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