MEDICARE: SANDRA WENTZEL HULS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	AP142488	TX

General Provider Information

NPI Number	:	1326697186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA WENTZEL HULS APRN

Provider Business Mailing Address
First Line	:	4040 LEA LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-9796
Country	:	US
Telephone Number	:	740-296-9347
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 NORTH LOOP W STE 670
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8119
Country	:	US
Telephone Number	:	281-673-4360
Fax Number	:	281-868-7036

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2019
Last Update Date	:	09/07/2023

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