Individual
RONALD C. WIEDOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1717 ROTARY DR, HUMBLE, TX 77338-5235
(281) 272-6277
(281) 272-6281
Mailing address
12221 N MO PAC EXPY, AUSTIN, TX 78758-2415
(512) 907-8748
(512) 901-8755
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G4746
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135895403
—
TX
Enumeration date
04/25/2006
Last updated
02/26/2019
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