Healthcare Provider Details

I. General information

NPI: 1013115260
Provider Name (Legal Business Name): AARON WELLS PT, MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 12/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E PALM VALLEY BLVD STE 395
ROUND ROCK TX
78664-4677
US

IV. Provider business mailing address

204 S INTERSTATE 35 STE 203
GEORGETOWN TX
78628-4126
US

V. Phone/Fax

Practice location:
  • Phone: 512-354-4067
  • Fax: 512-354-4068
Mailing address:
  • Phone: 512-863-7761
  • Fax: 512-863-0973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1202073
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: