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Individual

WENDELL A GROGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
22999 HIGHWAY 59 N STE 416, KINGWOOD, TX 77339-4412
(281) 359-5981
(281) 359-3591
Mailing address
PO BOX 9547, BELFAST, ME 04915-9547
(281) 359-5981
(281) 359-3591

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
M0740
TX
2084N0600X
Clinical Neurophysiology Physician
M0740
TX
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
M0740
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0026MH
BLUE CROSS BLUE SHIELD
TX
01
1590675
FIRST HEALTH
TX
05
172034401
TX
01
4462988
AETNA
TX
01
635873
MHHNP
TX
01
6700232
CIGNA
TX
Enumeration date
10/13/2006
Last updated
09/28/2015
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