Individual
DR. THEODORE FRANCIS WISSINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2727 W HOLCOMBE BLVD, HOUSTON, TX 77025-1669
(713) 442-0000
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-0000
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
Q5303
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355889201
—
TX
05
—
355889202
—
TX
Enumeration date
07/07/2009
Last updated
06/23/2021
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