Wanebo, Jackie E
Wanebo, Jackie E is an sole proprietor health care provider with primary practice located at 7900 Fannin St Suite #3300, Houston TX 77054-2934. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Wanebo, Jackie E can be contacted via phone (713) 630-0660.Contact Information
Primary practice address
7900 Fannin St Suite #3300
Houston TX 77054-2934
Phone: (713) 630-0660
Fax: (713) 796-2555
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | J9428 | Texas |
Profile Details
| NPI number | 1003981663 |
|---|---|
| LBN Legal business name | Wanebo, Jackie E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 21st, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003981663 | NPPES |
| Texas | MEDICAID | 127069603 |
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