Provider Demographics
NPI:1790499762
Name:TOOMBS, WENDY
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:TOOMBS
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 1:21810 CATOOSA DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-6900
Mailing Address - Country:US
Mailing Address - Phone:817-600-1659
Mailing Address - Fax:
Practice Address - Street 1:21810 CATOOSA DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-6900
Practice Address - Country:US
Practice Address - Phone:817-600-1659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-13
Last Update Date:2023-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX385H00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No385H00000XRespite Care FacilityRespite Care