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General NPI Number Information
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NPI Number | 1790787067
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Entity Type | Individual
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Provider Name | MICHAEL J. WELLS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 05/26/2022
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Provider Practice Location Address
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Address Line | 6100 WINDHAVEN PKWY
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City | PLANO
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State | TX
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Zip | 75093
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Country | US
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Telephone | 972-378-0620
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Fax | 972-378-0630
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Provider Business Mailing Address
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Address Line | 6100 WINDHAVEN PKWY
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City | PLANO
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State | TX
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Zip | 75093-8046
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Country | US
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Telephone | 972-378-0620
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Fax | 972-378-0630
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | L2052
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | L2052
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License Number State | TX
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