Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | BP10034943 | TX |
N | 111NI0900X | Internist | BP10034943 | TX |
Y | 207RG0100X | Gastroenterologist | Q4546 | TX |
NPI | 1013144641 |
---|---|
Provider Name | Dr. Jason Bennett Welch |
First Address | Dallas, TX 75284-4658 |
Second Address | Marble Falls, TX 78654-8606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2009 |
Last Update Date | 25/01/2022 |