MEDICARE: WENDY ALLISON PELS

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
1	183700000X	Pharmacy Technician	104303	TX

General Provider Information

NPI Number	:	1407689052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY ALLISON PELS

Provider Business Mailing Address
First Line	:	4691 STATE HIGHWAY 121
Second Line	:
City	:	THE COLONY
State	:	TX
Zip	:	75056-4010
Country	:	US
Telephone Number	:	972-625-3784
Fax Number	:	972-625-2534

Provider Business Practice Location Address
First Line	:	4691 STATE HIGHWAY 121
Second Line	:
City	:	THE COLONY
State	:	TX
Zip	:	75056-4010
Country	:	US
Telephone Number	:	972-625-3784
Fax Number	:	972-625-2534

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2024
Last Update Date	:	08/20/2024

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Directions to “ WENDY ALLISON PELS ” Practice Location

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