Provider Demographics
NPI:1215121462
Name:WEGLEIN, ADAM D (DO)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:D
Last Name:WEGLEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27385
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77227-7385
Mailing Address - Country:US
Mailing Address - Phone:281-888-3416
Mailing Address - Fax:281-888-3886
Practice Address - Street 1:6800 WEST LOOP S
Practice Address - Street 2:STE 500
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4528
Practice Address - Country:US
Practice Address - Phone:281-888-3416
Practice Address - Fax:281-888-3886
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5576207RS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine