Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 19828 | TX |
Y | 213EG0000X | General Practice | 19828 | TX |
NPI | 1003092461 |
---|---|
Provider Name | Dr. Kendra Steubing Wren |
First Address | Comfort, TX 78013-0096 |
Second Address | Comfort, TX 78013-3705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2008 |
Last Update Date | 16/01/2008 |