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General NPI Number Information
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NPI Number | 1558445833
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Entity Type | Organization
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Legal Business Name | WELLMEDICINE PLLC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 2710 HOSPITAL DR SUITE 108
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City | VICTORIA
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State | TX
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Zip | 77901
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Country | US
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Telephone | 361-579-1319
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Fax | 361-579-1317
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Provider Business Mailing Address
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Address Line | 1502 E. RED RIVER PMB 338
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City | VICTORIA
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State | TX
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Zip | 77901-5523
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Country | US
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Telephone | 361-579-1319
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Fax | 361-579-1317
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Authorized Official
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Title or Position | DR. NGUYEN/INTERNAL MEDICINE
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Name | DR. PETER MINH NGUYEN
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Credential |
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Telephone | 361-579-1319
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K4757
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License Number State | TX
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