Provider Demographics
NPI:1780749234
Name:WUPPER, JO L (MD)
Entity type:Individual
Prefix:
First Name:JO
Middle Name:L
Last Name:WUPPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 66159
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77266-6159
Mailing Address - Country:US
Mailing Address - Phone:713-526-0663
Mailing Address - Fax:713-526-0663
Practice Address - Street 1:42 CHELSEA BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-6245
Practice Address - Country:US
Practice Address - Phone:713-526-0663
Practice Address - Fax:713-526-0663
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6117207W00000X
NE16266207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology