Individual
CAROLYN WYLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2620 TANGLEWILDE ST, HOUSTON, TX 77063-3203
(713) 860-8383
(713) 860-8384
Mailing address
2620 TANGLEWILDE ST, HOUSTON, TX 77063-3203
(713) 860-8383
(713) 860-8384
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
DT04433
TX
Other
Enumeration date
05/30/2011
Last updated
05/30/2011
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