Organization
JONATHAN G WASH DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN GORDON WASH D.P.M. (OWNER)
(254) 741-1824
Entity
Organization
Contact information
Practice address
6609 SANGER AVE, WACO, TX 76710-4252
(254) 741-1824
(254) 741-1836
Mailing address
6609 SANGER AVE, WACO, TX 76710-4252
(254) 741-1824
(254) 741-1836
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178105601
—
TX
Enumeration date
05/18/2006
Last updated
06/20/2011
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