Organization
HARLAN WICHELHAUS, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARLAN P WICHELHAUS M.D. (OWNER/PHYSICIAN)
(409) 935-1988
Entity
Organization
Contact information
Practice address
1718 N AMBURN RD, SUITE B, TEXAS CITY, TX 77591-2490
(409) 935-1988
(409) 933-4898
Mailing address
1718 N AMBURN RD, SUITE B, TEXAS CITY, TX 77591-2490
(409) 935-1988
(409) 933-4898
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J0727
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0963910-01
—
TN
05
—
1720807-01
—
TX
Enumeration date
04/26/2006
Last updated
08/07/2012
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