Healthcare Provider Details

I. General information

NPI: 1760910921
Provider Name (Legal Business Name): CAITLIN WEHRLE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 11/08/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19655 WEST RD.
CYPRESS TX
77433
US

IV. Provider business mailing address

23515 KINGSLAND BLVD
KATY TX
77494
US

V. Phone/Fax

Practice location:
  • Phone: 281-769-8873
  • Fax: 281-769-8872
Mailing address:
  • Phone: 281-395-2112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019031131
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number33166
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: