Provider Demographics
NPI:1306328976
Name:WILSLEF, WENDY KAY
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:KAY
Last Name:WILSLEF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WINROCK BLVD APT 76
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4029
Mailing Address - Country:US
Mailing Address - Phone:832-651-8085
Mailing Address - Fax:
Practice Address - Street 1:2100 WINROCK BLVD APT 76
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4029
Practice Address - Country:US
Practice Address - Phone:832-651-8085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203112164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse