Organization
PHILIP A. WALLER, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP A WALLER MD, PA (OWNER)
(281) 481-8557
Entity
Organization
Contact information
Practice address
11003 RESOURCE PKWY STE 104, HOUSTON, TX 77089-6142
(281) 481-8557
(281) 484-7916
Mailing address
11003 RESOURCE PKWY STE 104, HOUSTON, TX 77089-6142
(281) 481-8557
(281) 484-7916
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
J3933
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588630578
INDIVIDUAL NPI
TX
01
—
5214420001
DME
TX
01
—
8AW783
BCBS
TX
01
—
P00063802
RRMC
TX
Enumeration date
10/19/2007
Last updated
05/01/2026
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