OrganizationActive
Shepherd Rural Health Clinic PA
NPI 1376629212 · Physician Assistant · Shepherd, TX
Provider details
- NPI number
- 1376629212
- Entity type
- Organization
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Philip Wisiackas, Physician(936) 628-3343
- License
- F4703 (TX)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
11 Woodland Park Drive
Shepherd, TX 77371
Phone: (936) 628-3343
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 669
Shepherd, TX 77371-0669
Registry dates
- Enumerated
- 2006-10-31
- Last updated
- 2010-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.