Individual
BLAIRE PETERSON VANDERWEELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6414 FANNIN ST STE G150, HOUSTON, TX 77030-1514
(225) 571-4128
(713) 486-7512
Mailing address
6414 FANNIN ST STE G150, HOUSTON, TX 77030-1514
(713) 486-7512
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
BP10097525
TX
Other
Enumeration date
05/27/2026
Last updated
05/27/2026
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