MEDICARE: DR. KAREN MONIQUE WUERTZ DDS

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	122300000X	Dentist	6896	NC
2	1223G0001X	General Practice Dentistry	16813	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346262201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN MONIQUE WUERTZ DDS

Provider Business Mailing Address
First Line	:	21822 JUNIPER WOOD LN
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-3636
Country	:	US
Telephone Number	:	757-409-9273
Fax Number	:

Provider Business Practice Location Address
First Line	:	7500 CAMBRIDGE ST RM 2548
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-2032
Country	:	US
Telephone Number	:	757-409-9273
Fax Number	:

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

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	11/09/2020

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