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NPI Code Detail

MEDICARE: JANIS A WELLS PT

MEDICARE:   JANIS A WELLS  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1003994TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000835OTHERMEDICARE GROUP #

General Provider Information

NPI Number : 1114097805
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANIS A WELLS PT
Provider Business Mailing Address
First Line : 30 DANA DR
Second Line :
City : NEW WAVERLY
State : TX
Zip : 77358
Country : US
Telephone Number : 979-285-5571
Fax Number : 844-364-2660
Provider Business Practice Location Address
First Line : 30 DANA DR
Second Line :
City : NEW WAVERLY
State : TX
Zip : 77358
Country : US
Telephone Number : 979-285-5571
Fax Number : 844-364-2660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 10/25/2021

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Directions to “ JANIS A WELLS PT” Practice Location

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