Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | E3619 | TX |
NPI | 1174584452 |
---|---|
Provider Name | Dr. Jerome Charles Wasserstein |
First Address | Houston, TX 77027-3164 |
Second Address | Houston, TX 77027-3164 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 08/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
133441902 | (05) | TX |
D97816 | (02) | TX |
P00087AP8 | (05) | TX |