Healthcare Provider Details

I. General information

NPI: 1992736490
Provider Name (Legal Business Name): EVELYN R WELCH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 WELLS CT
CEDAR HILL TX
75104-6952
US

IV. Provider business mailing address

4500 S. LANCASTER DEPT. OF VETERANS AFFAIRS
DALLAS TX
75216
US

V. Phone/Fax

Practice location:
  • Phone: 972-336-3681
  • Fax:
Mailing address:
  • Phone: 972-336-3681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberRN1005147
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: