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Individual

DR. KATHRYN DENISE WIESMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3533 S ALAMEDA ST, CORPUS CHRISTI, TX 78411-1721
(361) 694-5057
Mailing address
7777 FOREST LN STE C135, DALLAS, TX 75230-6825
(972) 347-4783

Taxonomy

Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
2015010246
MO
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
Q8221
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
362392802
TX
Enumeration date
06/13/2010
Last updated
01/04/2022
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