Provider Demographics
NPI:1033145685
Name:TJOA, WEILIE KRISTIN S
Entity Type:Individual
Prefix:DR
First Name:WEILIE
Middle Name:KRISTIN S
Last Name:TJOA
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 1:1315 ST JOSEPH PKWY
Mailing Address - Street 2:1007
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8233
Mailing Address - Country:US
Mailing Address - Phone:713-951-9996
Mailing Address - Fax:713-951-9394
Practice Address - Street 1:1315 ST JOSEPH PKWY
Practice Address - Street 2:1007
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-8233
Practice Address - Country:US
Practice Address - Phone:713-951-9996
Practice Address - Fax:713-951-9394
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-24
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6093174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00D868Medicaid
TX097934605Medicaid
TX097934605Medicaid
TX00D868Medicaid