Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | L5951 | TX |
Y | 2080P0210X | Pediatric Nephrologist | L5951 | TX |
NPI | 1922053701 |
---|---|
Provider Name | Scott E. Wenderfer |
First Address | Houston, TX 77046-0207 |
Second Address | Houston, TX 77030-2608 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 19/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
180248001 | (05) | TX |
180248003 | CSHCN (01) | TX |
8U4863 | BCBSTX (01) | TX |
I53711 | (02) |