Organization
J S WILKENFELD MD & ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN CANGELOSI MD (AUTHORIZING OFFICIAL)
(713) 559-6929
Entity
Organization
Contact information
Practice address
110 MEMORIAL HOSPITAL DR, HUNTSVILLE, TX 77340
(936) 291-4276
Mailing address
PO BOX 690129, HOUSTON, TX 77269-0129
(877) 787-9677
(855) 697-2447
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
D2317
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00D22V
BCBS
TX
05
—
082007801
—
TX
01
—
DG6808
RAILROAD MEDICARE
—
Enumeration date
01/31/2007
Last updated
08/11/2023
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