Individual
DR. JO ANNE WISE EDOKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
805 E 32ND ST, SUITE 102, AUSTIN, TX 78705-2537
(512) 582-1201
(512) 582-1205
Mailing address
805 E 32ND ST, SUITE 102, AUSTIN, TX 78705-2537
(512) 582-1201
(512) 582-1205
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
J3788
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133377508
—
TX
Enumeration date
09/26/2006
Last updated
06/30/2012
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