MEDICARE: JULIE WELDY

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	235Z00000X	Speech-Language Pathologist	18916	TX

General Provider Information

NPI Number	:	1609538941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE WELDY

Provider Business Mailing Address
First Line	:	PO BOX 490
Second Line	:
City	:	SOUR LAKE
State	:	TX
Zip	:	77659-0490
Country	:	US
Telephone Number	:	409-981-6440
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 HWY 326 SOUTH
Second Line	:
City	:	SOUR LAKE
State	:	TX
Zip	:	77659-0490
Country	:	US
Telephone Number	:	409-981-6440
Fax Number	:

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

Provider Enumeration Date	:	10/13/2021
Last Update Date	:	10/13/2021

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Directions to “ JULIE WELDY ” Practice Location

Language	Start Address	Practice Location

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