Individual
RALPH THANE WIEGMAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
643 S GREAT SOUTHWEST PKWY, STE 102, GRAND PRAIRIE, TX 75051-1056
(972) 647-0994
(972) 647-0521
Mailing address
643 S GREAT SOUTHWEST PKWY, STE 102, GRAND PRAIRIE, TX 75051-1056
(972) 647-0994
(972) 647-0521
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
F2113
TX
Other
Enumeration date
09/27/2005
Last updated
07/08/2007
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