Provider Demographics
NPI:1992382394
Name:WETTERMANN CAPO, RENATA YVONNE
Entity Type:Individual
Prefix:
First Name:RENATA
Middle Name:YVONNE
Last Name:WETTERMANN CAPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RENATA
Other - Middle Name:YVONNE
Other - Last Name:WETTERMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 BAYLOR PLZ # BCM320
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3498
Mailing Address - Country:US
Mailing Address - Phone:328-241-1170
Mailing Address - Fax:832-825-6497
Practice Address - Street 1:1 BAYLOR PLZ # BCM320
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3498
Practice Address - Country:US
Practice Address - Phone:832-824-1170
Practice Address - Fax:832-825-6497
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program