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General NPI Number Information
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NPI Number | 1720429061
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Entity Type | Individual
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Provider Name | GWENDOLYN WHIGHAM D.C.
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Gender | Female
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 10101 FONDREN RD SUITE 254
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City | HOUSTON
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State | TX
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Zip | 77096-4564
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Country | US
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Telephone | 832-880-5522
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Fax |
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Provider Business Mailing Address
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Address Line | 10101 FONDREN RD SUITE 254
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City | HOUSTON
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State | TX
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Zip | 77096-4564
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Country | US
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Telephone | 832-880-5522
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC4620
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111NI0013X
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Taxonomy Name | Independent Medical Examiner Chiropractor
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License Number | DC4620
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | DC4620
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | DC4620
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number | DC4620
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License Number State | TX
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