Individual
DR. MACKENZIE WEHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD464686
PA
207N00000X
Dermatology Physician
Primary
S3338
TX
207NS0135X
Procedural Dermatology Physician
MD464686
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
404224401
—
TX
01
—
404224402
MEDICAID-CSHCN
TX
01
—
8LW238
BCBS
TX
Enumeration date
05/23/2014
Last updated
12/23/2019
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