Provider Demographics
NPI:1174891246
Name:ADAM DAVID WEGLEIN DO & ASSOCIATES PA
Entity type:Organization
Organization Name:ADAM DAVID WEGLEIN DO & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WEGLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-888-3416
Mailing Address - Street 1:PO BOX 27385
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77227-7385
Mailing Address - Country:US
Mailing Address - Phone:281-888-3416
Mailing Address - Fax:
Practice Address - Street 1:6800 WEST LOOP S
Practice Address - Street 2:STE 500
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4528
Practice Address - Country:US
Practice Address - Phone:281-888-3416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5576207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Multi-Specialty