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Individual

MRS. GLENDA WEIDENDORF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NNP

Contact information

Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-7078
(210) 916-1744
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-7078
(210) 916-1744

Taxonomy

Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
664214
TX
363LN0000X
Neonatal Nurse Practitioner
Primary
AP129089
TX

Other

Enumeration date
06/03/2015
Last updated
01/24/2024
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