MEDICARE: DR. BRANDY N WELCH MD

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	208000000X	Pediatrics Physician	P7227	TX

General Provider Information

NPI Number	:	1528057544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDY N WELCH MD

Provider Business Mailing Address
First Line	:	PO BOX 961205
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76161-0205
Country	:	US
Telephone Number	:	817-740-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2875 MAIN ST STE 104
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75036-4594
Country	:	US
Telephone Number	:	214-872-1877
Fax Number	:	214-872-3114

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	04/12/2021

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