=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528268117
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLISON FLOYD WELLS M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2007
-----------------------------------------------------
Last Update Date | 08/19/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17207 KUYKENDAHL RD STE 200 NORTHWEST ANESTHESIA AND PAIN SERVICES
-----------------------------------------------------
City | SPRING
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77379-8423
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-698-5331
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7010 CHAMPIONS PLAZA DR
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77069-2396
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-698-5320
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | N5476
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------