Provider Demographics
NPI:1659569564
Name:MASAKI OISHI, M.D., P.A.
Entity Type:Organization
Organization Name:MASAKI OISHI, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:H
Authorized Official - Last Name:POTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-772-6760
Mailing Address - Street 1:7030 NEW SANGER RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-4075
Mailing Address - Country:US
Mailing Address - Phone:254-772-6760
Mailing Address - Fax:254-772-0050
Practice Address - Street 1:7030 NEW SANGER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-4075
Practice Address - Country:US
Practice Address - Phone:254-772-6760
Practice Address - Fax:254-772-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6133207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX166350201Medicaid
TX6192640001Medicare NSC
TX166350201Medicaid