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General NPI Number Information
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NPI Number | 1437354149
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Entity Type | Individual
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Provider Name | MRS. CHANDRA MARIE WELLS
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Gender | Female
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 1409 E 35TH ST
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City | HOUSTON
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State | TX
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Zip | 77022-6413
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Country | US
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Telephone | 713-859-5803
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Fax | 832-203-5274
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Provider Business Mailing Address
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Address Line | 18811 ORIOLE POINT CT
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City | CYPRESS
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State | TX
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Zip | 77429-8353
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Country | US
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Telephone | 713-859-5803
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Fax | 281-445-4415
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number | 001007876
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License Number State | TX
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