Provider Demographics
NPI:1427357797
Name:WOLFF, HERMAN WALTER JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:WALTER
Last Name:WOLFF
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:536 LILY LN
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:TX
Mailing Address - Zip Code:77488-4514
Mailing Address - Country:US
Mailing Address - Phone:979-532-4532
Mailing Address - Fax:
Practice Address - Street 1:536 LILY LN
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-4514
Practice Address - Country:US
Practice Address - Phone:979-532-4532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD1115208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery