Healthcare Provider Details

I. General information

NPI: 1659477222
Provider Name (Legal Business Name): WENDY S MARKOWITZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: WENDY S BLAIR M.D.

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 03/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1009 N 4TH ST
LONGVIEW TX
75601-4768
US

IV. Provider business mailing address

1009 N 4TH ST
LONGVIEW TX
75601-4768
US

V. Phone/Fax

Practice location:
  • Phone: 903-212-4330
  • Fax: 903-212-4333
Mailing address:
  • Phone: 903-212-4330
  • Fax: 903-212-4333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM8162
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: