Provider Demographics
NPI:1770765307
Name:WIK, GRETHE E (DO)
Entity type:Individual
Prefix:
First Name:GRETHE
Middle Name:E
Last Name:WIK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5080 SPECTRUM DR
Mailing Address - Street 2:SUITE 1200 WEST
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4648
Mailing Address - Country:US
Mailing Address - Phone:800-232-3550
Mailing Address - Fax:
Practice Address - Street 1:8868 RESEARCH BLVD
Practice Address - Street 2:SUITE 601
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-6497
Practice Address - Country:US
Practice Address - Phone:512-467-7232
Practice Address - Fax:512-467-7203
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG99022083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine