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General NPI Number Information
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NPI Number | 1376355099
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Entity Type | Individual
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Provider Name | FABIOLA WEGMANN FNP
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Gender | Female
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 10720 N LOOP DR STE A-6
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City | SOCORRO
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State | TX
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Zip | 79927-4409
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Country | US
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Telephone | 915-858-0500
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Fax | 915-858-0501
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Provider Business Mailing Address
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Address Line | 14321 DESERT SAGE DR
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City | HORIZON CITY
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State | TX
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Zip | 79928-6550
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Country | US
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Telephone | 915-274-4240
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1186739
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License Number State | TX
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