Individual
TARA L. WEGRYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6400 FANNIN ST, SUITE 2295, HOUSTON, TX 77030-1521
(713) 791-9778
(713) 791-9401
Mailing address
5116 BISSONNET ST # 202, BELLAIRE, TX 77401-4007
(713) 791-9778
(713) 791-9401
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
J1425
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126610804
—
TX
Enumeration date
10/20/2006
Last updated
11/11/2008
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