Provider Demographics
NPI:1750510145
Name:GIRARD, WENDY ALEJANDRA (MD)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:ALEJANDRA
Last Name:GIRARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:ALEJANDRA
Other - Last Name:RICHMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1925 EAST ORMAN AVENUE
Mailing Address - Street 2:SUITE A109
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004
Mailing Address - Country:US
Mailing Address - Phone:719-564-0210
Mailing Address - Fax:719-564-9483
Practice Address - Street 1:1925 EAST ORMAN AVENUE
Practice Address - Street 2:SUITE A109
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81004
Practice Address - Country:US
Practice Address - Phone:719-564-0210
Practice Address - Fax:719-564-9483
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0051561207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine