MEDICARE: WELLMAN STORES LLC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1699604645
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLMAN STORES LLC

Provider Business Mailing Address
First Line	:	500 N CAPITAL OF TEXAS HWY STE 112
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-3302
Country	:	US
Telephone Number	:	914-577-1352
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 N CAPITAL OF TEXAS HWY STE 112
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-3302
Country	:	US
Telephone Number	:	914-577-1352
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HAMZA KHOLIA
Credential	:
Telephone Number	:	914-577-1352

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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Directions to “WELLMAN STORES LLC ” Practice Location

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