Provider Demographics
NPI:1093279960
Name:ABELLAR, WENDY ZENAIDA PALMA
Entity Type:Individual
Prefix:
First Name:WENDY ZENAIDA
Middle Name:PALMA
Last Name:ABELLAR
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 1:530 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4110
Mailing Address - Country:US
Mailing Address - Phone:281-338-4004
Mailing Address - Fax:281-332-6524
Practice Address - Street 1:530 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4110
Practice Address - Country:US
Practice Address - Phone:281-338-4004
Practice Address - Fax:281-332-6524
Is Sole Proprietor?:No
Enumeration Date:2019-01-24
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137329363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX409160501Medicaid