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General NPI Number Information
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NPI Number | 1750128138
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Entity Type | Individual
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Provider Name | SAMMY WELBORN FNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/11/2024
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 20042 EVA ST
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City | MONTGOMERY
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State | TX
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Zip | 77356-2041
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Country | US
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Telephone | 936-207-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 35 SAM SLOTT RD
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City | NEW WAVERLY
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State | TX
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Zip | 77358
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Country | US
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Telephone | 936-662-7594
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1168774
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License Number State | TX
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