MEDICARE: MEDIWELL LABS

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	:	1720926546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDIWELL LABS

Provider Business Mailing Address
First Line	:	5005 W ROYAL LN STE 250
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-1961
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5005 W ROYAL LN STE 250
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75063-1961
Country	:	US
Telephone Number	:	945-387-5968
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BALAJI GAJULA
Credential	:
Telephone Number	:	945-387-5968

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “MEDIWELL LABS ” Practice Location

Language	Start Address	Practice Location

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