Individual
ELIZABETH J WANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 ALMA ST, STE 102, TOMBALL, TX 77375-4559
(281) 351-1411
(281) 351-0240
Mailing address
1101 ALMA ST, STE 102, TOMBALL, TX 77375-4559
(281) 351-1411
(281) 351-0240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H8495
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111660001
—
TX
Enumeration date
06/23/2005
Last updated
04/26/2012
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