Provider Demographics
NPI:1356789275
Name:WEGER, TRICIA DIANNE (MS-CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:TRICIA
Middle Name:DIANNE
Last Name:WEGER
Suffix:
Gender:F
Credentials:MS-CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 PINE DR
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5539
Mailing Address - Country:US
Mailing Address - Phone:713-405-9579
Mailing Address - Fax:
Practice Address - Street 1:3801 VISTA RD STE 200
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-2139
Practice Address - Country:US
Practice Address - Phone:713-910-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18637235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist