Healthcare Provider Details

I. General information

NPI: 1891908901
Provider Name (Legal Business Name): HAROLD MARK WELCH JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3019 MEDLIN DR SUITE 100
ARLINGTON TX
76015-2307
US

IV. Provider business mailing address

3019 MEDLIN DR SUITE 100
ARLINGTON TX
76015-2307
US

V. Phone/Fax

Practice location:
  • Phone: 817-465-7359
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberD3438
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: