TARA L WEGRYN MD PA
Medical Practice at Fannin St, Houston, TX

License number
Texas J1425
Category
Medical Practice
Type
Specialist
Owner
Name: TARA L WEGRYN MD
Title: OWNER
Phone: (713) 791-9778
Address
Address 2
6400 Fannin St SUITE 2295, Houston, TX 77030
5116 Bissonnet St, Bellaire, TX 77401
National Provider ID: 1033361936
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Tara L. Wegryn, M.D., PA

3433 Wickersham Ln, Houston, TX 77027

Industry:
Medical Doctor's Office
Principal:
Tara Wegryn (Principal)

TARA L. WEGRYN, M.D., PA

6400 Fannin St STE 2295, Houston, TX 77030

Status:
Inactive
Doing business as:
Tara L. Wegryn, M.D., PA
Registration:
Mar 21, 1997
State ID:
0081796003
Business type:
Professional Association
President , Treasurer , Director , Member , Secretary , Vice-President:
Tara L. Wegryn President , Treasurer , Director , Member , Secretary , Vice-President, inactive
Agent:
Simon Hendershot Iii,6400 Fannin, Houston, TX 77030 (Physical)
TIN:
32036010455

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