Individual
JEAN PATRICIA WADDLE
Active
Individual
JEAN PATRICIA WADDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
DR.0056738
CO
207L00000X
Anesthesiology Physician
K6400
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104199803
—
TX
05
—
104199806
—
TX
05
—
1457356610
—
CO
01
—
8EH613
BCBS
TX
01
—
P01446868
RR
TX
Enumeration date
06/15/2005
Last updated
10/29/2018
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