Provider Demographics
NPI:1295887206
Name:PICKARD GOSSETT & SAWISKY LLP
Entity type:Organization
Organization Name:PICKARD GOSSETT & SAWISKY LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:SAWISKY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:409-722-0026
Mailing Address - Street 1:1039 N TWIN CITY HWY STE B
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-3851
Mailing Address - Country:US
Mailing Address - Phone:409-722-0026
Mailing Address - Fax:409-729-2783
Practice Address - Street 1:1039 N TWIN CITY HWY STE B
Practice Address - Street 2:
Practice Address - City:NEDERLAND
Practice Address - State:TX
Practice Address - Zip Code:77627-3851
Practice Address - Country:US
Practice Address - Phone:409-722-0026
Practice Address - Fax:409-729-2783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1569600-01Medicaid
TX0066JQOtherBLUE CROSS GROUP