Individual
P.J. TISCH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2929 RESEARCH PARKWAY, COLLEGE STATION, TX 77843-4243
(979) 845-3109
Mailing address
4603 PRO CT, COLLEGE STATION, TX 77845-4419
(512) 673-3697
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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