MEDICARE: WESLEY WAYNE NEWELL D.D.S.

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	1223G0001X	General Practice Dentistry	13785	TX

General Provider Information

NPI Number	:	1851408611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WESLEY WAYNE NEWELL D.D.S.

Provider Business Mailing Address
First Line	:	4550 POST OAK PLACE DR
Second Line	:	SUITE 345
City	:	HOUSTON
State	:	TX
Zip	:	77027-3165
Country	:	US
Telephone Number	:	713-622-4485
Fax Number	:	713-622-2237

Provider Business Practice Location Address
First Line	:	4550 POST OAK PLACE DR
Second Line	:	SUITE 345
City	:	HOUSTON
State	:	TX
Zip	:	77027-3165
Country	:	US
Telephone Number	:	713-622-4485
Fax Number	:	713-622-2237

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

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	08/07/2020

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