Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1007050 | TX |
NPI | 1023636321 |
---|---|
Provider Name | Eleanor Weltge |
First Address | Houston, TX 77030-1527 |
Second Address | Houston, TX 77030-1527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2020 |
Last Update Date | 29/11/2021 |